十七年的前瞻性队列研究显示，肝硬化病人的HCV基因型1b是发生癌变的主要危险因素

Title: Hepatitis C virus genotype 1b as a major risk factor associated with hepatocellular carcinoma in patients with cirrhosis: A seventeen-year prospective cohort study.
题目： 丙型肝炎病毒基因型1b是导致肝硬化患者发生癌变的主要危险因素：一项17年的前瞻性队列研究
Author: Bruno S, Crosignani A, Maisonneuve P, Rossi S, Silini E, Mondelli MU.
作者：Bruno S, Crosignani A, Maisonneuve P, Rossi S, Silini E, Mondelli MU.

Source: Hepatology. 2007 Aug 6; [Epub ahead of print]
来源：Hepatology. 2007 Aug 6; [Epub ahead of print]

Hepatocellular carcinoma (HCC) is the most frequent cause of death in patients with hepatitis C virus (HCV)-induced cirrhosis. Despite a number of studies in different populations worldwide suggesting an association between HCV genotype 1 and the risk of HCC, no consensus has emerged yet on this matter, which is still controversial.
肝细胞癌(hepatocellular carcinoma，HCC)是丙型肝炎后肝硬化患者最常见的死亡原因。尽管世界上许多的不同人口的研究表明，丙型肝炎病毒基因型1b与肝细胞癌的发病风险有关，但尚未达成共识，争议仍然存在。
In an attempt to clarify this issue, a prospective study of 163 consecutive HCV-positive patients with cirrhosis, who were enrolled between January 1989 and December 1990, was carried out. HCC occurrence was detected by ultrasound surveillance every 6 months. Independent predictors of HCC were assessed with a Cox regression analysis.
为了阐明这一问题，我们对1989年1月至1990年12月间，163名连续丙型肝炎后肝硬化患者进行了前瞻性的研究。每6个月通过超声监测肝细胞癌的发病情况。肝细胞癌的独立预测指标通过Cox回归分析进行评定。
After a median follow-up of 10.7 years, 44 [4.26/100/year, confidence interval (CI) = 3.11-5.68/100/year] of 104 patients infected with genotype 1b developed HCC versus 10 (1.69/100/year, CI = 0.82-3.09/100/year) of 52 patients infected with genotype 2a/c (P = 0.0001). Multivariate analysis showed that HCV genotype 1b was independently associated with HCC development [hazard ratio (HR) = 3.02, 95% CI = 1.40-6.53]. Other predictors of HCC were esophageal varices (HR = 2.15, 95% CI = 1.03-4.47), male gender (HR = 2.12, 95% CI = 1.10-4.11), and age over 60 years (HR = 5.96, 95% CI = 1.23-28.8).
经过平均10.7年的随访，在104名感染丙型肝炎病毒基因型1b的患者中有44名[4.26/100/年,可信区间(CI) = 3.11-5.68/100/年]发生HCC，而在52名感染丙型肝炎病毒基因型2a/c的患者中有10名(1.69/100/年, CI = 0.82-3.09/100/年)发生肝细胞癌。多变量分析显示：丙型肝炎病毒基因型1b独立与肝细胞癌的发生有关[危害比 (HR) = 3.02, 95% CI = 1.40-6.53]。其他的预测指标包括食管静脉曲张(危害比= 2.15, 95% CI = 1.03-4.47)，男性(HR = 2.12, 95% CI = 1.10-4.11)，以及年龄60岁以上(HR = 5.96, 95% CI = 1.23-28.8)。
Conclusion: HCV genotype 1b is associated with a statistically significant higher risk of developing HCC. Patients with cirrhosis that are infected with this genotype require more intensive surveillance for the early detection and aggressive management of neoplasia. (HEPATOLOGY 2007.).
结论：丙型肝炎病毒基因型1b与肝细胞癌的患病风险增高相关，具有统计学意义。感染这种基因型病毒的肝硬化患者更需要加强肿瘤早期发现的监测和肿瘤的积极治疗。(HEPATOLOGY 2007.).

PMID: 17680653

编译：
题目： 丙型肝炎病毒基因型1b是导致肝硬化患者发生癌变的主要危险因素：一项17年的前瞻性队列研究
作者：Bruno S, Crosignani A, Maisonneuve P, Rossi S, Silini E, Mondelli MU.
来源：Hepatology. 2007 Aug 6; [Epub ahead of print]
肝细胞癌(hepatocellular carcinoma，HCC)是丙型肝炎后肝硬化患者最常见的死亡原因。尽管世界上许多不同人口的研究表明，丙型肝炎病毒基因型1b与肝细胞癌的发病风险有关，但尚未达成共识，仍然存在争议。
为了阐明这一问题，我们对1989年1月至1990年12月间，163名连续丙型肝炎后肝硬化患者进行了前瞻性的研究。每6个月通过超声监测肝细胞癌的发病情况。肝细胞癌的独立预测指标通过Cox回归分析进行评定。
经过平均10.7年的随访，在104名感染丙型肝炎病毒基因型1b的患者中有44名[4.26/100/年,可信区间(CI) = 3.11-5.68/100/年]发生HCC，而在52名感染丙型肝炎病毒基因型2a/c的患者中有10名(1.69/100/年, CI = 0.82-3.09/100/年)发生肝细胞癌。多变量分析显示：丙型肝炎病毒基因型1b独立与肝细胞癌的发生有关[危害比 (HR) = 3.02, 95% CI = 1.40-6.53]。其他的预测指标包括食管静脉曲张(危害比= 2.15, 95% CI = 1.03-4.47)，男性(HR = 2.12, 95% CI = 1.10-4.11)，以及年龄60岁以上(HR = 5.96, 95% CI = 1.23-28.8)。
结论：丙型肝炎病毒基因型1b与肝细胞癌的患病风险增高相关，具有统计学意义。感染这种基因型病毒的肝硬化患者更需要加强肿瘤早期发现的监测和肿瘤的积极治疗。(HEPATOLOGY 2007.).