《美國醫學會雜誌》11月14日發表的一篇論文研究調查了核苷類似物的使用和乙肝病毒（HBV）相關肝細胞癌肝切除後複發風險。

　　對HBV相關肝癌肝髒切除後的病人來說，腫瘤複發是主要問題。

　　中國台灣的Chun-Ying Wu醫生和同事研究了核苷類似物的使用和HBV相關肝細胞癌根治性手術後腫瘤複發風險。

　　研究者對2003年和2010年之間台灣省內（病例）進行隊列/群組研究。資料來自於台灣全民健康保險研究資料庫。

　　在近期被診斷為肝細胞癌的100938例患者中，研究小組選取了2003至2010年之間4569例進行了根治性肝切除的HBV相關肝細胞癌患者。

　　小組研究成果主要比較了未使用和使用核苷類似物的病人第一次腫瘤複發風險。

　　研究小組發現與非治療組相比，治療組有更高的肝硬化的發病率。但其肝細胞癌複發風險和整體死亡（率）較低。

　　研究小組總結道：“在HBV相關肝細胞癌病人肝切除後，使用核苷類似物與更低的肝細胞癌複發風險相關。”

與乙型肝炎相關的拓展閱讀：

　　Association Between Nucleoside Analogues and Risk of Hepatitis B Virus–Related Hepatocellular Carcinoma Recurrence Following Liver ResectionContext　Tumor recurrence is a major issue for patients with hepatocellular carcinoma (HCC) following curative liver resection.Objective　To investigate the association between nucleoside analogue use and risk of tumor recurrence in patients with hepatitis B virus (HBV) related HCC after curative surgery.Design, Setting, and Participants　A nationwide cohort study between October 2003 and September 2010. Data from the Taiwan National Health Insurance Research Database. Among 100 938 newly diagnosed HCC patients, we identified 4569 HBV-related HCC patients who received curative liver resection for HCC between October 2003 and September 2010.Main Outcome Measures　The risk of first tumor recurrence was compared between patients not taking nucleoside analogues (untreated cohort, n = 4051) and patients taking nucleoside analogues (treated cohort, n = 518). Cumulative incidences and hazard ratios (HRs) were calculated after adjusting for competing mortality.Results　The treated cohort had a higher prevalence of liver cirrhosis when compared with the untreated cohort (48.6% vs 38.7%; P < .001), but lower risk of HCC recurrence (n = 106 [20.5%] vs n = 1765 [43.6%]; P < .001), and lower overall death (n = 55 [10.6%] vs n = 1145 [28.3%]; P < .001). After adjusting for competing mortality, the treated cohort had a significantly lower 6-year HCC recurrence rate (45.6%; 95% CI, 36.5%-54.6% vs untreated, 54.6%; 95% CI, 52.5%-56.6%; P < .001). Six-year overall mortalities for treated cohorts were 29.0% (95% CI, 20.0%-38.0%) and for untreated 42.4% (95% CI, 40.0%-44.7%; P < .001). On modified Cox regression analysis, nucleoside analogue use (HR, 0.67; 95% CI, 0.55-0.81; P < .001), statin use (HR, 0.68; 95% CI, 0.53-0.87; P = .002), and nonsteroidal anti-inflammatory drugs or aspirin use (HR, 0.80; 95% CI, 0.73-0.88; P < .001) were independently associated with a reduced risk of HCC recurrence. Multivariable stratified analyses verified the association in all subgroups of patients, including those who were noncirrhotic (HR, 0.56; 95% CI, 0.42-0.76) and diabetic (HR, 0.52; 95% CI, 0.31-0.89).Conclusion　Nucleoside analogue use was associated with a lower risk of HCC recurrence among patients with HBV-related HCC after liver resection.

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