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对慢性病毒性肝炎感染患者应用干扰素治疗可以阻止病情进展为肝癌

作者: 张茜茜 发布日期: 2012-07-13 阅读次数:
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 摘要:持续的乙型肝炎或丙型肝炎病毒感染是发生肝癌的主要病因。就像欧美国家一样,肝癌患者的例数在亚非国家也在增长。对于B型慢性肝病患者,干扰素治疗可以阻止肝癌发生。然而,并没有足够的证据证实干扰素治疗可以阻止慢性乙肝患者发展为肝癌。几乎没有几例肝癌是因为乙肝感染引起的,而且长期随访研究并没有发现干扰素治疗可以阻止慢乙肝患者发展为肝癌。为了提高B型慢性肝病患者的预后,把年龄及肝纤维化程度等影响抗病毒治疗的因素考虑进去是很重要的。对于慢性丙型肝炎,干扰素治疗的持续病毒学应答能阻止肝癌的发生,并能改善预后,然而,对于C型慢性肝脏疾病,以持续病毒学应答为目标的治疗需要考虑宿主和病毒两方面的因素。在肝癌发病率低的地区(如美国),还需要大量病例和长期随访才能证实干扰素治疗可以抑制肝脏癌变。在局部治疗后应用干扰素可以抑制疾病复发,并提高生存率。

 

吉林大学第一医院肝胆胰内科  张茜茜  摘译

本文首次发表于[Hepatol Res. 2012,42(1):22-32. ]

 

Anticarcinogenic impact of interferon therapy on the progression of hepatocellular carcinoma in patients with chronic viral infection

AbstractHepatocellular carcinoma (HCC) is mainly caused by a persistent infection due to the hepatitis B or hepatitis C virus. The number of HCC cases is increasing in Asian and African countries, as well as in European and American countries. Interferon (IFN) therapy, used for type B chronic liver diseases, inhibits hepatic carcinogenesis in patients with compensated cirrhosis. However, there is insufficient evidence that IFN therapy inhibits hepatic carcinogenesis in patients with chronic hepatitis B.There are few cases of HCC due to chronic hepatitis B, and long-term follow-up periods verifying the inhibitory effect of IFN on hepatic carcinogenesis have not been obtained. To improve the prognosis of type B chronic liver diseases, it is important that hepatitis treatment follows guidelines in which a patient’s age and the extent of hepatic fibrosis are taken into account. As for chronic hepatitis C, since a sustained virological response (SVR) in IFN therapy inhibits hepatic carcinogenesis and improves prognosis, treatment that aims for an SVR while taking into consideration host-sided and virus-sided factors is recommended for patients with type C chronic liver diseases.In areas with low incidence of HCC (e.g. USA), a large number of cases and a long-term follow-up period are needed before it can be accepted that IFN therapy inhibits hepatic carcinogenesis. After locally curative treatment of HCC, IFN therapy suppresses recurrence and improves survival rates.

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作者: 张茜茜 发布日期: 2012-07-13 阅读次数: