Hepatit B’ye bağlı siroz hastalarında hepatosellüler karsinom gelişiminde prediktif faktörlerin incelenmesi
Abstract
Giriş ve Amaç: Bu çalışmanın amacı kronik hepatit B’ye bağlı siroz hastalarında, hepatosellüler karsinom gelişimini etkileyen faktörlerin değerlendirilmesidir. Gereç ve Yöntem: Ocak 2010 - Ocak 2019 yılları arasında Demiroğlu Bilim Üniversitesi Tıp Fakültesi gastroenteroloji polikliniğinde hepatit B virüsüne bağlı karaciğer sirozu nedeniyle takip edilen 18 yaş üstü 324 hasta çalışmaya dahil edildi. Olguların demografik (yaş, cinsiyet), beden kitle indeksi, laboratuvar [biyokimyasal ve serolojik parametreler (hepatit B yüzey antijeni, hepatit b virüs-DNA)], görüntüleme ve biyopsi sonuçları hastane bilgi sisteminden retrospektif olarak toplandı. Hastalar hepatosellüler karsinom ve non- hepatosellüler karsinom olarak iki gruba ayrıldı. Bulgular: Çalışmaya dahil edilen hastaların 114’ü hepatosellüler karsinom ve 210’u ise non- hepatosellüler karsinom sirozlu idi. Hastaların yaş ortalaması 54.50±9.30 idi. Hepatosellüler karsinom ile non-hepatosellüler karsinom grupları karşılaştırıldığında yaş ortalaması, Homeostatic Model of Assessment Insulin Resistance, hepatit B virüs-DNA ve alfa fetoprotein değerleri hepatosellüler karsinom grubunda istatistiksel olarak daha yüksek saptandı. Asit, özofagus varis kanaması ve hepatik ensefalopati non-hepatosellüler karsinom grubunda daha yüksek oranda görülürken, spontan bakteriyel peritonit ise hepatosellüler karsinom grubunda istatistiksel olarak daha yüksek oranda bulundu. Hepatosellüler karsinom oluşumunu öngörebilecek bağımsız risk faktörleri incelendiğinde, alfa fetoprotein ve hepatit B virüs-DNA değerlerinin istatistiksel olarak bağımsız risk faktörü olduğu görüldü (sırasıyla; p=0.001 ve p=0.037). Sonuç: Çalışmamızda hepatit B virüsüne bağlı siroz hastalarında hepatosellüler karsinom için alfa fetoprotein ve hepatit B virüs-DNA değerleri bağımsız risk faktörü olarak saptandı. Alfa fetoprotein ve hepatit B virüs-DNA değerleri hepatit B virüsüne bağlı siroz hastalarında hepatosellüler karsinom gelişiminde kullanışlı birer belirteç olabilir.
Keywords
References
- 1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005;55:74-108.
- 2. Chang UK, Kim MS, Han CJ, Lee DH. Clinical result of stereotactic radiosurgery for spinal metastasis from hepatocellular carcinoma: comparison with conventional radiation therapy. J Neurooncol 2014;119:141-8.
- 3. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Tobacco smoke and involuntary smoking. IARC Monogr Eval Carcinog Risks Hum 2004;83:1-1438.
- 4. Yeo Y, Gwack J, Kang S, et al. Viral hepatitis and liver cancer in Korea: an epidemiological perspective. Asian Pac J Cancer Prev 2013;14:6227-31.
- 5. Simonetti RG, Camma C, Fiorello F, et al. Hepatitis C virus infection as a risk factor for hepatocellular carcinoma in patients with cirrhosis. A case-control study. Ann Intern Med 1992;116:97-102.
- 6. Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinomain cirrhosis: incidence and risk factors. Gastroenterology 2004;127:35-50.
- 7. Lok ASF. Hepatitis B infection: Pathogenesis and management. J Hepatology 2000;32:89-97.
- 8. Torbenson M, Thomas DL. Occult hepatitis B. Lancet Infect Dis 2002;2:479-86.
- 9. Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol 2006;45:529-38.
- 10. Gurtsevitch VE. Human oncogenic viruses: hepatitis B and hepatitis C viruses and their role in hepatocarcinogenesis. Biochemistry 2008;73:504-13.
- 11. Chen XL, Xu YY, Chen L, Wang GL, Shen Y. TLR3 plays significant roles against HBV-associated HCC. Gastroenterol Res Pract 2015;2015:572171.
- 12. Tantiwetrueangdet A, Panvichian R, Sornmayura P, Sueangoen N, Leelaudomlipi S. Reduced HBV cccDNA and HBsAg in HBV-associated hepatocellular carcinoma tissues. Med Oncol 2018;35:127.
- 13. Wei Y, Ye W, Zhao W. Serum iron levels decreased in patients with HBV-related hepatocellular carcinoma, as a risk factor for the prognosis of HBV-related HCC. Front Physiol 2018;9:66.
- 14. Ferlay J, Soerjamataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359-86.
- 15. Wang M, Xi D, Ning Q. Virus-induced hepatocellular carcinoma with special emphasis on HBV. Hepatol Int 2017;11:171-80.
- 16. Daud M, Rana MA, Husnain T, Ijaz B. Modulation of Wnt signaling pathway by hepatitis B virus. Arch Virol 2017;162:2937-47.
- 17. Gao J, Xiong Y, Wang Y, et al. Hepatitis B virus X protein activates Notch signaling by its effects on Notch1 and Notch4 in human hepatocellular carcinoma. Int J Oncol 2016;48:329-37.
- 18. Yoneda M, Hyun J, Jakubski S, et al. Hepatitis B Virus and DNA Stimulation Trigger a Rapid Innate Immune Response through NF-κB. J Immunol 2016;197:630-43.
- 19. Yang JD, Kim WR, Coelho R, et al. Cirrhosis is present in most patients with hepatitis B and hepatocellular carcinoma. Clin Gastroenterol Hepatol 2011;9:64-70.
- 20. Tsukuma H, Hiyama T, Tanaka S, et al. Risk factors for hepatocellular carcinoma among patients with chronic liver disease. N Engl J Med 1993; 328:1797-801.
- 21. Colombo M, de Franchis R, Del Ninno E, et al. Hepatocellular carcinoma in Italian patients with cirrhosis. N Engl J Med 1991;325:675-80.
- 22. Hoshida Y. Risk of recurrence in hepatitis B‐related hepatocellular carcinoma: impact of viral load in late recurrence. J Hepatol 2009;51:842-44.
- 23. Beasley RP, Hwang LY, Lin CC, Chien CS. Hepatocellular carcinoma and hepatitis B virus. A prospective study of 22,707 men in Taiwan. Lancet 1981;2:1129-33.
Abstract
References
- 1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005;55:74-108.
- 2. Chang UK, Kim MS, Han CJ, Lee DH. Clinical result of stereotactic radiosurgery for spinal metastasis from hepatocellular carcinoma: comparison with conventional radiation therapy. J Neurooncol 2014;119:141-8.
- 3. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Tobacco smoke and involuntary smoking. IARC Monogr Eval Carcinog Risks Hum 2004;83:1-1438.
- 4. Yeo Y, Gwack J, Kang S, et al. Viral hepatitis and liver cancer in Korea: an epidemiological perspective. Asian Pac J Cancer Prev 2013;14:6227-31.
- 5. Simonetti RG, Camma C, Fiorello F, et al. Hepatitis C virus infection as a risk factor for hepatocellular carcinoma in patients with cirrhosis. A case-control study. Ann Intern Med 1992;116:97-102.
- 6. Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinomain cirrhosis: incidence and risk factors. Gastroenterology 2004;127:35-50.
- 7. Lok ASF. Hepatitis B infection: Pathogenesis and management. J Hepatology 2000;32:89-97.
- 8. Torbenson M, Thomas DL. Occult hepatitis B. Lancet Infect Dis 2002;2:479-86.
- 9. Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol 2006;45:529-38.
- 10. Gurtsevitch VE. Human oncogenic viruses: hepatitis B and hepatitis C viruses and their role in hepatocarcinogenesis. Biochemistry 2008;73:504-13.
- 11. Chen XL, Xu YY, Chen L, Wang GL, Shen Y. TLR3 plays significant roles against HBV-associated HCC. Gastroenterol Res Pract 2015;2015:572171.
- 12. Tantiwetrueangdet A, Panvichian R, Sornmayura P, Sueangoen N, Leelaudomlipi S. Reduced HBV cccDNA and HBsAg in HBV-associated hepatocellular carcinoma tissues. Med Oncol 2018;35:127.
- 13. Wei Y, Ye W, Zhao W. Serum iron levels decreased in patients with HBV-related hepatocellular carcinoma, as a risk factor for the prognosis of HBV-related HCC. Front Physiol 2018;9:66.
- 14. Ferlay J, Soerjamataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359-86.
- 15. Wang M, Xi D, Ning Q. Virus-induced hepatocellular carcinoma with special emphasis on HBV. Hepatol Int 2017;11:171-80.
- 16. Daud M, Rana MA, Husnain T, Ijaz B. Modulation of Wnt signaling pathway by hepatitis B virus. Arch Virol 2017;162:2937-47.
- 17. Gao J, Xiong Y, Wang Y, et al. Hepatitis B virus X protein activates Notch signaling by its effects on Notch1 and Notch4 in human hepatocellular carcinoma. Int J Oncol 2016;48:329-37.
- 18. Yoneda M, Hyun J, Jakubski S, et al. Hepatitis B Virus and DNA Stimulation Trigger a Rapid Innate Immune Response through NF-κB. J Immunol 2016;197:630-43.
- 19. Yang JD, Kim WR, Coelho R, et al. Cirrhosis is present in most patients with hepatitis B and hepatocellular carcinoma. Clin Gastroenterol Hepatol 2011;9:64-70.
- 20. Tsukuma H, Hiyama T, Tanaka S, et al. Risk factors for hepatocellular carcinoma among patients with chronic liver disease. N Engl J Med 1993; 328:1797-801.
- 21. Colombo M, de Franchis R, Del Ninno E, et al. Hepatocellular carcinoma in Italian patients with cirrhosis. N Engl J Med 1991;325:675-80.
- 22. Hoshida Y. Risk of recurrence in hepatitis B‐related hepatocellular carcinoma: impact of viral load in late recurrence. J Hepatol 2009;51:842-44.
- 23. Beasley RP, Hwang LY, Lin CC, Chien CS. Hepatocellular carcinoma and hepatitis B virus. A prospective study of 22,707 men in Taiwan. Lancet 1981;2:1129-33.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | December 25, 2019 |
| Published in Issue | Year 2019 Volume: 18 Issue: 3 |
test-5