医学
肝细胞癌
内科学
胃肠病学
阶段(地层学)
相伴的
入射(几何)
瞬态弹性成像
肝纤维化
肝活检
纤维化
慢性肝炎
活检
免疫学
古生物学
病毒
物理
光学
生物
作者
Hsin‐Ming Wang,Chao‐Hung Hung,Sheng‐Nan Lu,Chien‐Hung Chen,Chuan‐Mo Lee,Tsung‐Hui Hu,Jing‐Houng Wang
摘要
Abstract Background Hepatic fibrosis stage is useful in assessing risk of hepatocellular carcinoma ( HCC ) occurrence. Aim To evaluate liver stiffness measurement ( LSM ), in addition to fibrosis stage, in risk assessment of long‐term HCC occurrence for patients with chronic hepatitis C. Patients and methods Consecutive patients with chronic hepatitis C, without past history and presence of HCC , with concomitant liver biopsy and LSM were enrolled in this study. All patients attended regular surveillance for HCC development every 3–12 months. The medical records were reviewed. Follow‐up LSM was performed at least 1 year later. Results One hundred and ninety‐eight patients (M/F: 112/86) with reliable LSM results were enrolled. Ten patients developed HCC in a median follow‐up period of 47.8 months. For patients with initial LSM >24 kPa, 12–24 kPa, and <12 kPa, 5‐ year HCC incidence was 45.1%, 9.5% and 0.9% respectively. Multivariate analysis showed patients with LSM >24 kPa and patients with LSM 12–24 kPa had higher risks of HCC development ( HR : 24.6, CI : 2.7–220.4 and HR :11.7, CI :1.3–105.2). Patients without sustained virological response after treatment also had higher risk of HCC occurrence ( HR : 9.7, CI : 1.1–82.2). Among 106 patients with follow‐up LSM , there was a higher risk of HCC development for patients with LSM >12 kPa in the initial and follow‐up LSM . Conclusion As an alternative of fibrosis stage, initial LSM is useful as a non‐invasive method in risk assessment of HCC occurrence for patients with chronic hepatitis C. Serial follow‐up LSM>12 kPa carries higher risk of HCC development.
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