干扰素与核苷(酸)类似物治疗对乙型肝炎相关肝细胞癌的影响

Effect of interferon or nucleos(t)ide analogs on hepatitis B-related hepatocellular carcinoma

乙型肝炎病毒(HBV)感染是我国患者发生肝硬化、肝细胞肝癌(HCC)最重要的危险因素,干扰素(IFN)与核背(酸)类似物(NA)是目前治疗慢性乙型肝炎的两大类药物。有大量的临床研究证实,通过NAs治疗可明显降低慢性乙型肝炎患者的肝癌发生风险。也有一些前瞻性研究证实,IFN的治疗同样能减少慢性乙型肝炎患者的肝癌发生风险。只有几项、样本量有限的临床研究,比较了这两类药物在降低HCC发生率方面的差异,尽管结果提示IFN能较NA治疗减少更多的肝癌发生,但对研究结论需谨慎看待,未来还需要多中心、大样本、设计严谨的前瞻性研究来证实。

Hepatitis B virus(HBV)infection is the most important risk factor for cirrhosis and hepatocellular carcinoma(HCC)in Chinese patients.Interferon(IFN)and nucleos(t)ide analogues(NAs)are two major regimens for chronic hepatitis B(CHB).A large number of clinical studies have previously confirmed that the risk of HCC in CHB patients can be significantly reduced by NAs treatment.There are also some prospective studies confirming the benefit of IFN treatment.However,only a few clinical studies with limited sample size have directly compared the differences in the incidence of HCC between these two classes of drugs.Although these results suggested that the risk of HCC in IFN group was lower than patients in NA group,the conclusion need to be taken with caution.In the future,a multi-center,large sample size,well-designed,prospective study will be needed to answer this question.