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請使用永久網址來引用或連結此文件:
https://nccur.lib.nccu.edu.tw/handle/140.119/75239
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| 題名: | Risk stratification for hepatitis B virus related hepatocellular carcinoma |
| 作者: | Lin, Chih-Lin;Kao, J.-H.
林志陵 |
| 貢獻者: | 心理系 |
| 關鍵詞: | alanine aminotransferase;hepatitis B surface antigen;virus DNA;adult;aged;alanine aminotransferase blood level;article;cancer risk;deletion mutant;female;genotype;hepatitis B;human;liver cell carcinoma;male;priority journal;quantitative analysis;risk assessment;virus carrier;virus load;virus mutant;virus replication |
| 日期: | 2013-01 |
| 上傳時間: | 2015-05-21 16:33:45 (UTC+8) |
| 摘要: | Hepatitis B virus (HBV) infection is the major cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC) worldwide, especially in the Asia-Pacific region. Several hepatitis B viral factors predictive of clinical outcomes in HBV carriers have been identified. The Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer-HBV (REVEAL-HBV) study from Taiwan illustrated the strong association between HBV-DNA level at study entry and risk of HCC over time. In this community-based cohort study, male gender, older age, high serum alanine aminotransferase level, positive hepatitis B e antigen, higher HBV-DNA level, HBV genotype C infection, and core promoter mutation are independently associated with a higher risk of HCC. Another large hospital-based Elucidation of Risk Factors for Disease Control or Advancement in Taiwanese Hepatitis B Carriers cohort of Taiwanese patients further validated the findings of REVEAL-HBV. The risk of HCC started to increase when HBV-DNA level was higher than 2000IU/mL. Both HBV-DNA and HBsAg levels were shown to be associated with HCC development. While HBV-DNA level had better predictive accuracy than HBsAg level, when investigating the overall cohort in patients with HBV-DNA level<2000IU/mL, HBsAg level≥1000IU/mL was identified as a new independent risk factor for HCC. With the results from REVEAL-HBV, a risk calculation for predicting HCC in non-cirrhotic patients has been developed and validated by independent cohorts (Risk Estimation for Hepatocellular Carcinoma in Chronic Hepatitis B).Taken together, ample evidence indicates that HBsAg level can complement HBV-DNA level in predicting HCC development, especially in HBV carriers with low viral load. In conclusion, HBV treatment guidelines should include the risk stratification of HCC to individualize the management of HBV carriers with different levels of HCC risk. © 2012 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd. |
| 關聯: | Journal of Gastroenterology and Hepatology (Australia), 28(1), 10-17 |
| 資料類型: | article |
| DOI 連結: | http://dx.doi.org/10.1111/jgh.12010 |
| DOI: | 10.1111/jgh.12010 |
| 顯示於類別: | [心理學系] 期刊論文
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文件中的檔案:
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| 10-17.pdf | | 302Kb | Adobe PDF2 | 706 | 檢視/開啟 |
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