A comparison between HCV-related hepatocellular carcinoma patients with or without  direct acting antivirals treatment

Abstract

Abstract: Objective To compare the hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) in patients with or without receiving direct antiviral antivirals (DAAs). Methods Seventy three cases of HCV-related HCC enrolled from March 2018 to June 2021 were reviewed, including 58 males and 15 females, aged 56 (44, 76) years. They were divided into a DAAs group and a non-DAAs group according to whether DAAs treatment had been applied or not. The diagnosis of the disease met the requirements. The baseline data, oncological features and tumor stages (BCLC stage, TNM stage and CLIP score) of HCV-related HCC cases were collected and compared. Results There were 21 cases in DAAs group and 52 cases in non-DAAs group respectively. Abdominal pain, ascites, lower limb edema, jaundice and fatigue in DAAs group were 16 cases (76.2%), 2 cases (9.5%), 1 case (4.8%), and 1 case (4.8%), respectively, which were significantly different with those of 1 case (4.8%), 17 cases (32.7%), 15 cases (8.8%), 11 cases (21.1%), 9 cases (17.3%), 0 case (0) in non-DAAs group (P<0.05). There were 10 cases (47.6%) of portal vein thrombosis in DAAs group, which were significantly higher than those of 12 cases (23.1%) in non-DAAs group (P<0.05). There were 6 cases (28.6%) of Lymph node metastasis in DAAs group, which were significantly higher than those of 3 cases (5.8%) in non-DAAs group [ P<0.05]. The BCLC stages (0, A, B, C, D) in DAAs group were 2 cases (9.5%), 2 cases (9.5%), 3 cases (14.3%), 9 cases (42.8%) and 5 cases (23.8%) in each stage, while those in non-DAAs group were 6 cases (11.5%), 19 cases (36.5%), 16 cases (30.8%), 4 cases (7.7%), and 7 cases (13.5%), respectively, the difference was statistically significant (P<0.05). The TNM stages (Ⅰ, Ⅱ, Ⅲ, Ⅳ) in DAAs group were 2 cases (9.5%), 3 cases (14.3%), 10 cases (47.6%) and 6 cases (28.6%) in each stage, while those in non-DAAs group were 27 cases (51.9%), 12 cases (23.1%) and 8 cases (15.4%), respectively, the difference was statistically significant (P<0.05). The CLIP scores (0, 1, 2, 3, 4~6) of DAAs group were 2 (9.5%), 5 (23.8%), 2 (9.5%), 3 (14.3%) and 9 (42.8%), while those of non-DAAs group were 12 (23.1%), 15 (28.8%), 11(21.1%), 13(25.0%), and 1(1.9%), respectively, the difference was also statistically significant (P<0.05). Conclusion Chronic hepatitis C patients need long-term HCC monitoring even after DAAs treatment.

Key words: Hepatitis C virus, Direct acting antivirals, Hepatocellular carcinoma, BCLC stage

JIN Zhi-en, XU pan, YUAN Hong-wei, XU Jing-jiang. A comparison between HCV-related hepatocellular carcinoma patients with or without direct acting antivirals treatment[J]. Chinese Hepatolgy, 2023, 28(6): 680-682.

References

[1] Baumert TF, Berg T, Lim JK, et al. Status of direct-acting antiviral therapy for hepatitis C virus infection and remaining challenges. Gastroenterology, 2019, 156(2):431-445.
[2] Cabral LKD, Grisetti L, Pratama MY, et al. Biomarkers for the detection and management of hepatocellular carcinoma in patients treated with direct-acting antivirals. Cancers (Basel), 2022, 14(11):2700.
[3] Reig M, Mariño Z, Perelló C, et al. Unexpected high rate of early tumor recurrence in patients with HCV-related HCC undergoing interferon-free therapy. J Hepatol, 2016, 65(4):719-726.
[4] Renzulli M, Buonfiglioli F, Conti F, et al. Imaging features of microvascular invasion in hepatocellular carcinoma developed after direct-acting antiviral therapy in HCV-related cirrhosis. Eur Radiol, 2018, 28(2):506-513.
[5] Calvaruso V, Cabibbo G, Cacciola I, et al. Incidence of hepatocellular carcinoma in patients with HCV-associated cirrhosis treated with direct-acting antiviral agents. Gastroenterology, 2018, 155(2):411-421.e4.
[6] Romano A, Angeli P, Piovesan S, et al. Newly diagnosed hepatocellular carcinoma in patients with advanced hepatitis C treated with DAAs: a prospective population study. J Hepatol, 2018, 69(2):345-352.
[7] Ioannou GN, Green PK, Berry K. HCV eradication induced by direct-acting antiviral agents reduces the risk of hepatocellular carcinoma. J Hepatol, 2017, S0168-8278(17)32273-0.
[8] 中华医学会肝病学分会, 中华医学会感染病学分会. 丙型肝炎防治指南(2019年版). 实用肝脏病杂志, 2020, 23(1): 后插33-后插52.
[9] Abdelaziz AO, Nabil MM, Abdelmaksoud AH, et al. Tumor behavior of hepatocellular carcinoma after hepatitis C treatment by direct-acting antivirals: comparative analysis with non-direct-acting antivirals-treated patients. Eur J Gastroenterol Hepatol, 2019, 31(1):75-79.
[10] Bruden DJT, McMahon BJ, Townshend-Bulson L, et al. Risk of end-stage liver disease, hepatocellular carcinoma, and liver-related death by fibrosis stage in the hepatitis C Alaska Cohort. Hepatology, 2017, 66(1):37-45.
[11] Okuda H, Nakanishi T, Takatsu K, et al. Serum levels of des-gamma-carboxy prothrombin measured using the revised enzyme immunoassay kit with increased sensitivity in relation to clinicopathologic features of solitary hepatocellular carcinoma. Cancer, 2000, 88(3):544-549.
[12] Liu C, Xiao GQ, Yan LN, et al. Value of α-fetoprotein in association with clinicopathological features of hepatocellular carcinoma. World J Gastroenterol, 2013, 19(11):1811-1819.
[13] Han K, Tzimas GN, Barkun JS, et al. Preoperative alpha-fetoprotein slope is predictive of hepatocellular carcinoma recurrence after liver transplantation. Can J Gastroenterol, 2007, 21(1):39-45.
[14] Huang CM, Hu TH, Chang KC, et al. Dynamic noninvasive markers predict hepatocellular carcinoma in chronic hepatitis C patients without sustained virological response after interferon-based therapy: Prioritize who needs urgent direct-acting antiviral agents. Medicine (Baltimore), 2017, 96(46):e8696.
[15] Kwon JH, Yoo SH, Nam SW, et al. Clinical outcomes after the introduction of direct antiviral agents for patients infected with genotype 1b hepatitis C virus depending on the regimens: a multicenter study in Korea. J Med Virol, 2019, 91(6):1104-1111.

A comparison between HCV-related hepatocellular carcinoma patients with or without direct acting antivirals treatment

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	GUO Dan-dan, QIN Ling, GAO Weng-feng, YUAN Chun-wang, ZHANG Ying-hua, ZHANG Yong-hong. Correlation between the plasma levels of interleukin-33 and hepatocellular carcinoma, thermal ablation therapy [J]. Chinese Hepatolgy, 2023, 28(6): 665-667.
[2]	MA Bo-heng, WANG Xia, WU Ying. An evaluation of serum biochemical indexes, pathological characteristics and surgical treatment efficacy of sarcomatoid hepatocellular carcinoma [J]. Chinese Hepatolgy, 2023, 28(6): 676-679.
[3]	YAN Jing-quan, LIU Juan, LU Xue-lan, LAN Yun-cui, LIN Zhan-zhou. Effect of direct antivirals on liver fibrosis in patients with persistently virologically responsive chronic hepatitis C [J]. Chinese Hepatolgy, 2023, 28(5): 530-533.
[4]	QIAN Hou-long, LI Yang, ZHU Xiang, LU Kui. The efficacy and safety of carrilizumab combined with ramvaritinib in the treatment of unresectable hepatocellular carcinoma [J]. Chinese Hepatolgy, 2023, 28(4): 452-456.
[5]	ZHU Jia-zuo, ZHAO Ji-guang, CHENG Zhi-yuan. The efficacy and safety of different doses of apatinib combined with carelizumab in the treatment of advanced liver cancer [J]. Chinese Hepatolgy, 2023, 28(4): 457-460.
[6]	HU Bo-bin, WANG Rong-ming, LIANG Heng-kai, WEI Lu, LI Qing-mei, SU Tu-mei, YIN Qian-bing, JIANG Jian-ning. Expression of ESPL1 gene in hepatocellular carcinoma tissue and its role in the prognosis assessment [J]. Chinese Hepatolgy, 2023, 28(3): 285-289.
[7]	LI Peng, WANG Wei-wei, CAI Jian-ming, DONG Jing-hui. Consistency analysis of major signs of small liver cancer LI-RADS (2018 edition) [J]. Chinese Hepatolgy, 2023, 28(3): 293-295.
[8]	SU Pei-hua, WEI Meng-ping, ZHAO Cai-yan. Influence on chronic hepatitis B combined with nonalcoholic fatty liver disease on the development of hepatocellular carcinoma and all-cause mortality: A meta-analysis [J]. Chinese Hepatolgy, 2023, 28(3): 299-304.
[9]	HAO Shuai, YAN Hong-lin, KONG Fan-jiao, ZHANG Xiao-ying, HAN Yang, GUO Fei-hu, HE Na. Application of retrospective follow-up in improving diagnosis and treatment of hepatitis C virus in hospitalized patients [J]. Chinese Hepatolgy, 2023, 28(3): 305-308.
[10]	LIU Yun-xiao, FU Yan, NIU Li-na, DOU Jing , WANG Xiao-zhong. Effect of Nucleos(t)ide analogues(NAs) therapy on the postoperative survival in patients with hepatitis B virus related hepatocellular carcinoma-a meta analysis [J]. Chinese Hepatolgy, 2023, 28(2): 181-188.
[11]	HE Zheng-yang, SHE Wei-ming. Retrospective cohort study on traditional chinese medicine dialectical treatment improving survival rate of patients with hepatocellular carcinoma after radical resection [J]. Chinese Hepatolgy, 2023, 28(2): 189-192.
[12]	YIN Wei, FENG Yu-cheng, LUO Song-zhi, DAI Sheng-dao. An analysis on the consistency between arterial phase diagnosis of contrast-enhanced ultrasound and pathological results of micro-hepatocellular carcinoma in the context of liver cirrhosis [J]. Chinese Hepatolgy, 2023, 28(2): 200-202.
[13]	SHI Xu, QIAO Xiang-bin, LIU Jia, XIAO Bao-jun. Contrast ultrasonography and CEUS LI-RADS standard classification of DN-HCC and DN patients were observed [J]. Chinese Hepatolgy, 2023, 28(1): 79-82.
[14]	YIN Rui, YIN Hui-kang, GENG Cheng-jun. The value of of MSCT and dynamic contrast-enhanced MRI in differential diagnosis of HCC and IHPCC [J]. Chinese Hepatolgy, 2023, 28(1): 83-85.
[15]	MU Zhi-yong, LIU Yu-yi, WANG Jun, CHEN Dong-feng, WEN Liang-zhi. Correlation between transjugular intrahepatic portal shunt and hepatocellular carcinoma: A systematic review and meta-analysis [J]. Chinese Hepatolgy, 2022, 27(9): 978-982.