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Secondary prevention of recurrence by interferon therapy after ablation therapy for hepatocellular carcinoma in chronic hepatitis C patients

机译:慢性丙型肝炎肝细胞癌消融治疗后干扰素治疗的二级预防

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摘要

Chronic hepatitis C is a leading cause of hepatocellular carcinoma (HCC) worldwide. Interferon (IFN) therapy decreases the incidence of HCC in patients with chronic hepatitis C. Prevention of chronic-hepatitis-C-related HCC is one of the most important issues in current hepatology. We have previously reported that male gender and high titer of hepatitis C virus (HCV) RNA are predictive factors for the development of HCC in HCV-related cirrhosis. Clinical efforts at eradicating or reducing the viral load may reduce the risk for HCC. Furthermore, because HCC often recurs after ablation therapy, we performed a trial of IFN in patients with chronic liver disease caused by HCV to see whether IFN therapy decreases recurrence after ablation therapy of HCV-related HCC. By using IFN therapy as a secondary prevention, patients with HCC who had received complete tumor ablation showed better survival, primarily as a result of the preservation of liver function and also probably prevention of recurrence. Postoperative IFN therapy appears to decrease recurrence after ablation therapy such as radiofrequency ablation (RFA) therapy of HCV-related HCC. We believe that there is a survival benefit in secondary prevention using IFN therapy. However, a controlled study is essential to obtain conclusive evidence of the efficacy of this strategy.
机译:慢性丙型肝炎是全球肝细胞癌(HCC)的主要原因。干扰素(IFN)治疗可降低慢性丙型肝炎患者HCC的发生率。预防与慢性C型肝炎相关的HCC是当前肝病学中最重要的问题之一。我们以前曾报道过,男性和丙型肝炎病毒(HCV)RNA高滴度是HCV相关性肝硬化中HCC发生的预测因素。临床上为消除或减少病毒载量所做的努力可能会降低HCC的风险。此外,由于消融治疗后HCC经常复发,我们对由HCV引起的慢性肝病患者进行了IFN试验,以观察IFN治疗是否会降低HCV相关HCC消融治疗后的复发率。通过使用IFN治疗作为辅助预防措施,已完全切除肿瘤的HCC患者表现出更好的生存率,这主要是由于保留了肝功能并可能预防了复发。术后IFN治疗似乎会减少消融治疗(例如HCV相关HCC的射频消融(RFA)治疗)后的复发率。我们相信使用IFN治疗的二级预防有生存益处。但是,进行对照研究对于获得该策略有效性的确凿证据至关重要。

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