Objective： To compare the clinical characteristics and prognosis between hepatitis virus-related hepatocellular carcinoma（viral HCC） and non-B, non-C HCC（NBC-HCC） among Uyghur patients in Xinjiang province, China...Objective： To compare the clinical characteristics and prognosis between hepatitis virus-related hepatocellular carcinoma（viral HCC） and non-B, non-C HCC（NBC-HCC） among Uyghur patients in Xinjiang province, China. Methods： Between 01/01/2000 and 31/12/2012, 319 Uyghur HCC patients were treated at the Cancer Centre of The First Affiliated Hospital of Xinjiang Medical University. The data for the patients were obtained from a retrospective review of the patients＇ medical records. A total of 18 patients were excluded from the study because of incomplete information. The patients were classified into two groups： viral HCC and NBC-HCC. The clinical characteristics and prognostic factors were statistically analysed.Results： For all 301 patients, gender（P=0.000）, area of residence（P=0.002）, diabetes mellitus（P=0.009）, BMI（P=0.000）, cirrhosis（P=0.000）, tumour stage（P=0.004）, Child-Pugh class（P=0.000）, the TBIL level（P=0.000）, and the alpha-fetoprotein（AFP） level（P=0.000） were significantly different between the NBC-HCC and viral HCC groups. The NBC-HCC patients tended to be diagnosed at advanced stages; however, the NBC-HCC patients exhibited lower Child-Pugh scores than the viral HCC patients. In all patients examined, the 0.5-, 1-, 3- and 5-year overall survival（OS） rates were 35.6%, 20.3%, 12.6% and 4.5%, respectively. No significant difference in OS was observed between the two groups（P=0.124）. Cox multivariate analysis revealed that age（RR =1.539, P=0.001）, TNM stage（RR =12.708, P=0.000）, portal vein tumour thrombus（PVTT）（RR =2.003, P=0.000）, Child-Pugh class（RR =1.715, P=0.000）, and TACE ＋ radiotherapy/RFA（RR =0.567, P=0.000） were significant independent prognostic factors for HCC patients. Conclusions： The clinical characteristics differ between Uyghur patients with NBC-HCC and viral HCC. HCC in the Xinjiang region displays specific regional characteristics. Age, TNM stage, PVTT, Child-Pugh class and TACE ＋ radiotherapy/RFA are significant risk factors that influence patient survival.展开更多
There are cases of hepatitis involving occult hepatitis B virus(HBV)infection in which,even though the HB surface antigen(HBsAg)is negative,HBV-DNA is detected by a polymerase chain reaction(PCR).We con-ducted a seque...There are cases of hepatitis involving occult hepatitis B virus(HBV)infection in which,even though the HB surface antigen(HBsAg)is negative,HBV-DNA is detected by a polymerase chain reaction(PCR).We con-ducted a sequence analysis of the entire HBV region in a case of non-B non-C chronic hepatitis in a 46-yearold female.A diagnosis of non-B non-C chronic hepatitis was made.Although HBV markers,such as HBs antibody(anti-HBs),anti-HBc,HBeAg and anti-HBe,were negative,HBV-DNA was positive.Nested PCR was performed to amplify the precore region of HBV-DNA and all remaining regions by long nested PCR.Sequence analysis of the two obtained bands was conducted by direct sequencing.Compared with the control strains,the ATG(Methionine)start codon in the X region had mut ated to GTG(Valine).It is assumed that a mutation at the start codon in the X region may be the reason why HBV markers are negative in some cases of hepatitis that involve occult HBV infection.展开更多
AIM To investigate the prevalence, clinicopathological characteristics and surgical outcomes of occult hepatitis B virus(HBV) infection(OBI) in patients with non-B, non-C(NBNC) hepatocellular carcinoma(HCC).METHODS Th...AIM To investigate the prevalence, clinicopathological characteristics and surgical outcomes of occult hepatitis B virus(HBV) infection(OBI) in patients with non-B, non-C(NBNC) hepatocellular carcinoma(HCC).METHODS This study retrospectively examined the cases of 78 NBNC patients with curative resection for HCC for whom DNA could be extracted from formalin-fixed paraffin-embedded tissue. OBI was determined by the HBV-DNA amplification of at least two different sets of primers by TaqM an realtime polymerase chain reaction. Possibly carcinogenetic factors such as alcohol abuse, diabetes mellitus, obesity and non-alcoholic steatohepatitis(NASH) were examined. Surgical outcomes were evaluated according to diseasefree survival(DFS), overall survival(OS) and diseasespecific survival(DSS).RESULTS OBI was found in 27/78 patients(34.6%) with NBNC HCC. The OBI patients were significantly younger than the non-OBI cases at the time of surgery(average age 63.0 vs 68.1, P = 0.0334) and the OBI cases overlapped with other etiologies significantly more frequently compared to the non-OBI cases(P = 0.0057). OBI had no impact on the DFS, OS or DSS. Only tumorrelated factors affected these surgical outcomes.CONCLUSION Our findings indicate that OBI had no impact on surgical outcomes. The surgical outcomes of NBNC HCC depend on early tumor detection; this reconfirms the importance of a periodic medical examination for individuals who have NBNC HCC risk factors.展开更多
To analyzed the correlation between smoking status and surgical outcomes in patients with non-B non-C hepatocellular carcinoma (NBNC-HCC), and we investigated the patients’ clinicopathological characteristics accordi...To analyzed the correlation between smoking status and surgical outcomes in patients with non-B non-C hepatocellular carcinoma (NBNC-HCC), and we investigated the patients’ clinicopathological characteristics according to smoking status.METHODSWe retrospectively analyzed the consecutive cases of 83 NBNC-HCC patients who underwent curative surgical treatment for the primary lesion at Saga University Hospital between 1984 and December 2012. We collected information about possibly carcinogenic factors such as alcohol abuse, diabetes mellitus, obesity and smoking habit from medical records. Smoking habits were subcategorized as never, ex- and current smoker at the time of surgery. The diagnosis of non-alcoholic steatohepatitis (NASH) was based on both clinical information and pathological confirmation.RESULTSAlcohol abuse, diabetes mellitus, obesity and NASH had no significant effect on the surgical outcomes. Current smoking status was strongly correlated with both overall survival (P = 0.0058) and disease-specific survival (P = 0.0105) by multivariate analyses. Subset analyses revealed that the current smokers were significantly younger at the time of surgery (P = 0.0002) and more likely to abuse alcohol (P = 0.0188) and to have multiple tumors (P = 0.023).CONCLUSIONCurrent smoking habit at the time of surgical treatment is a risk factor for poor long-term survival in NBNC-HCC patients. Current smokers tend to have multiple HCCs at a younger age than other patients.展开更多
目的观察脂必泰胶囊治疗非酒精性脂肪肝合并慢性乙型病毒性肝炎患者的疗效及作用机制。方法纳入非酒精性脂肪肝并乙型病毒性肝炎患者100例,采用随机数字分组法分为观察组和对照组各50例,对照组50例予富马酸替诺福韦25 mg,1次/d,观察组5...目的观察脂必泰胶囊治疗非酒精性脂肪肝合并慢性乙型病毒性肝炎患者的疗效及作用机制。方法纳入非酒精性脂肪肝并乙型病毒性肝炎患者100例,采用随机数字分组法分为观察组和对照组各50例,对照组50例予富马酸替诺福韦25 mg,1次/d,观察组50例加予脂必泰胶囊0.24 g 2粒/次,2次/d,疗程2个月,期间两组均予西医常规对症治疗手段。比较两组治疗前后肝功能[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰转移酶(γ-GT)]、血脂[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、肾功能[尿素氮(BUN)、肌酐(Cr)]、HBV-DNA量、中医证候积分变化情况。结果试验结束后,观察组总有效率为94%(47/50),较对照组的80%(40/50)高;与治疗前相比,两组患者肝肾功能、血脂、HBV-DNA量中医证候积分均较治疗前有所改善。观察组ALT、AST、γ-GT改善程度较对照组优(P<0.05);TC、TG、LDL-C降低程度比对照组高、HDL-C改善程度较优(P<0.05);中医证候积分显著改善(P<0.05)。结论脂必泰胶囊可有效改善非酒精性脂肪肝合并肝硬化患者血脂水平、肝肾功能、协助抑制HBV病毒复制延缓病程进展且安全系数较高,可为该疾病临床治疗方案制定提供有效参考。展开更多
目的基于机器学习算法,构建太原市乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阳性母亲婴儿乙型肝炎疫苗无/弱应答的风险预测模型,为此类高风险婴儿的早期识别和预防提供参考。方法选取2019年11月—2023年10月在太原市第三人...目的基于机器学习算法,构建太原市乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阳性母亲婴儿乙型肝炎疫苗无/弱应答的风险预测模型,为此类高风险婴儿的早期识别和预防提供参考。方法选取2019年11月—2023年10月在太原市第三人民医院妇产科分娩的HBsAg阳性产妇及其分娩的婴儿作为研究对象,采用问卷调查和病历查阅方式收集数据。采用多因素logistic回归分析模型筛选危险因素,采用5折交叉验证划分数据集,采用合成少数样本过采样方法对训练集数据进行重采样处理后,分别构建logistic回归、极端梯度提升(extreme gradient boosting,XGBoost)、决策树、随机森林模型,并采用受试者工作特性曲线下面积(area under the curve,AUC)评价模型预测性能。结果共收集到HBsAg阳性母婴253对,其中无/弱应答率为10.28%(26/253)。Logistic回归分析模型结果显示,母亲乙型肝炎病毒DNA载量、新生儿髓样分化因子88蛋白百分比、磷酸化核因子κB蛋白百分比、浆细胞百分比是婴儿乙型肝炎疫苗无/弱应答的影响因素。将以上因素纳入预测模型,在验证集中各模型AUC均>0.800,其中以XGBoost算法构建的预测模型效能最佳(AUC=0.919)。结论基于机器学习算法,尤其是XGBoost算法,建立的太原市HBsAg阳性母亲婴儿乙型肝炎疫苗无/弱应答风险预测模型具有较好的效能,有助于预测婴儿乙型肝炎疫苗无/弱应答发生。展开更多
基金supported by a grant from the Urumqi Science and Technology Project Foundation of China(No.H111313001)
文摘Objective： To compare the clinical characteristics and prognosis between hepatitis virus-related hepatocellular carcinoma（viral HCC） and non-B, non-C HCC（NBC-HCC） among Uyghur patients in Xinjiang province, China. Methods： Between 01/01/2000 and 31/12/2012, 319 Uyghur HCC patients were treated at the Cancer Centre of The First Affiliated Hospital of Xinjiang Medical University. The data for the patients were obtained from a retrospective review of the patients＇ medical records. A total of 18 patients were excluded from the study because of incomplete information. The patients were classified into two groups： viral HCC and NBC-HCC. The clinical characteristics and prognostic factors were statistically analysed.Results： For all 301 patients, gender（P=0.000）, area of residence（P=0.002）, diabetes mellitus（P=0.009）, BMI（P=0.000）, cirrhosis（P=0.000）, tumour stage（P=0.004）, Child-Pugh class（P=0.000）, the TBIL level（P=0.000）, and the alpha-fetoprotein（AFP） level（P=0.000） were significantly different between the NBC-HCC and viral HCC groups. The NBC-HCC patients tended to be diagnosed at advanced stages; however, the NBC-HCC patients exhibited lower Child-Pugh scores than the viral HCC patients. In all patients examined, the 0.5-, 1-, 3- and 5-year overall survival（OS） rates were 35.6%, 20.3%, 12.6% and 4.5%, respectively. No significant difference in OS was observed between the two groups（P=0.124）. Cox multivariate analysis revealed that age（RR =1.539, P=0.001）, TNM stage（RR =12.708, P=0.000）, portal vein tumour thrombus（PVTT）（RR =2.003, P=0.000）, Child-Pugh class（RR =1.715, P=0.000）, and TACE ＋ radiotherapy/RFA（RR =0.567, P=0.000） were significant independent prognostic factors for HCC patients. Conclusions： The clinical characteristics differ between Uyghur patients with NBC-HCC and viral HCC. HCC in the Xinjiang region displays specific regional characteristics. Age, TNM stage, PVTT, Child-Pugh class and TACE ＋ radiotherapy/RFA are significant risk factors that influence patient survival.
文摘There are cases of hepatitis involving occult hepatitis B virus(HBV)infection in which,even though the HB surface antigen(HBsAg)is negative,HBV-DNA is detected by a polymerase chain reaction(PCR).We con-ducted a sequence analysis of the entire HBV region in a case of non-B non-C chronic hepatitis in a 46-yearold female.A diagnosis of non-B non-C chronic hepatitis was made.Although HBV markers,such as HBs antibody(anti-HBs),anti-HBc,HBeAg and anti-HBe,were negative,HBV-DNA was positive.Nested PCR was performed to amplify the precore region of HBV-DNA and all remaining regions by long nested PCR.Sequence analysis of the two obtained bands was conducted by direct sequencing.Compared with the control strains,the ATG(Methionine)start codon in the X region had mut ated to GTG(Valine).It is assumed that a mutation at the start codon in the X region may be the reason why HBV markers are negative in some cases of hepatitis that involve occult HBV infection.
文摘AIM To investigate the prevalence, clinicopathological characteristics and surgical outcomes of occult hepatitis B virus(HBV) infection(OBI) in patients with non-B, non-C(NBNC) hepatocellular carcinoma(HCC).METHODS This study retrospectively examined the cases of 78 NBNC patients with curative resection for HCC for whom DNA could be extracted from formalin-fixed paraffin-embedded tissue. OBI was determined by the HBV-DNA amplification of at least two different sets of primers by TaqM an realtime polymerase chain reaction. Possibly carcinogenetic factors such as alcohol abuse, diabetes mellitus, obesity and non-alcoholic steatohepatitis(NASH) were examined. Surgical outcomes were evaluated according to diseasefree survival(DFS), overall survival(OS) and diseasespecific survival(DSS).RESULTS OBI was found in 27/78 patients(34.6%) with NBNC HCC. The OBI patients were significantly younger than the non-OBI cases at the time of surgery(average age 63.0 vs 68.1, P = 0.0334) and the OBI cases overlapped with other etiologies significantly more frequently compared to the non-OBI cases(P = 0.0057). OBI had no impact on the DFS, OS or DSS. Only tumorrelated factors affected these surgical outcomes.CONCLUSION Our findings indicate that OBI had no impact on surgical outcomes. The surgical outcomes of NBNC HCC depend on early tumor detection; this reconfirms the importance of a periodic medical examination for individuals who have NBNC HCC risk factors.
文摘To analyzed the correlation between smoking status and surgical outcomes in patients with non-B non-C hepatocellular carcinoma (NBNC-HCC), and we investigated the patients’ clinicopathological characteristics according to smoking status.METHODSWe retrospectively analyzed the consecutive cases of 83 NBNC-HCC patients who underwent curative surgical treatment for the primary lesion at Saga University Hospital between 1984 and December 2012. We collected information about possibly carcinogenic factors such as alcohol abuse, diabetes mellitus, obesity and smoking habit from medical records. Smoking habits were subcategorized as never, ex- and current smoker at the time of surgery. The diagnosis of non-alcoholic steatohepatitis (NASH) was based on both clinical information and pathological confirmation.RESULTSAlcohol abuse, diabetes mellitus, obesity and NASH had no significant effect on the surgical outcomes. Current smoking status was strongly correlated with both overall survival (P = 0.0058) and disease-specific survival (P = 0.0105) by multivariate analyses. Subset analyses revealed that the current smokers were significantly younger at the time of surgery (P = 0.0002) and more likely to abuse alcohol (P = 0.0188) and to have multiple tumors (P = 0.023).CONCLUSIONCurrent smoking habit at the time of surgical treatment is a risk factor for poor long-term survival in NBNC-HCC patients. Current smokers tend to have multiple HCCs at a younger age than other patients.
文摘目的观察脂必泰胶囊治疗非酒精性脂肪肝合并慢性乙型病毒性肝炎患者的疗效及作用机制。方法纳入非酒精性脂肪肝并乙型病毒性肝炎患者100例,采用随机数字分组法分为观察组和对照组各50例,对照组50例予富马酸替诺福韦25 mg,1次/d,观察组50例加予脂必泰胶囊0.24 g 2粒/次,2次/d,疗程2个月,期间两组均予西医常规对症治疗手段。比较两组治疗前后肝功能[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰转移酶(γ-GT)]、血脂[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、肾功能[尿素氮(BUN)、肌酐(Cr)]、HBV-DNA量、中医证候积分变化情况。结果试验结束后,观察组总有效率为94%(47/50),较对照组的80%(40/50)高;与治疗前相比,两组患者肝肾功能、血脂、HBV-DNA量中医证候积分均较治疗前有所改善。观察组ALT、AST、γ-GT改善程度较对照组优(P<0.05);TC、TG、LDL-C降低程度比对照组高、HDL-C改善程度较优(P<0.05);中医证候积分显著改善(P<0.05)。结论脂必泰胶囊可有效改善非酒精性脂肪肝合并肝硬化患者血脂水平、肝肾功能、协助抑制HBV病毒复制延缓病程进展且安全系数较高,可为该疾病临床治疗方案制定提供有效参考。
文摘目的基于机器学习算法,构建太原市乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阳性母亲婴儿乙型肝炎疫苗无/弱应答的风险预测模型,为此类高风险婴儿的早期识别和预防提供参考。方法选取2019年11月—2023年10月在太原市第三人民医院妇产科分娩的HBsAg阳性产妇及其分娩的婴儿作为研究对象,采用问卷调查和病历查阅方式收集数据。采用多因素logistic回归分析模型筛选危险因素,采用5折交叉验证划分数据集,采用合成少数样本过采样方法对训练集数据进行重采样处理后,分别构建logistic回归、极端梯度提升(extreme gradient boosting,XGBoost)、决策树、随机森林模型,并采用受试者工作特性曲线下面积(area under the curve,AUC)评价模型预测性能。结果共收集到HBsAg阳性母婴253对,其中无/弱应答率为10.28%(26/253)。Logistic回归分析模型结果显示,母亲乙型肝炎病毒DNA载量、新生儿髓样分化因子88蛋白百分比、磷酸化核因子κB蛋白百分比、浆细胞百分比是婴儿乙型肝炎疫苗无/弱应答的影响因素。将以上因素纳入预测模型,在验证集中各模型AUC均>0.800,其中以XGBoost算法构建的预测模型效能最佳(AUC=0.919)。结论基于机器学习算法,尤其是XGBoost算法,建立的太原市HBsAg阳性母亲婴儿乙型肝炎疫苗无/弱应答风险预测模型具有较好的效能,有助于预测婴儿乙型肝炎疫苗无/弱应答发生。
