[Risk assessment of hepatocellular carcinoma in patients with hepatitis B-related cirrhosis and hypertension: a propensity score matching-based retrospective cohort study].

Q3 Medicine 南方医科大学学报杂志 Pub Date : 2024-11-20 DOI:10.12122/j.issn.1673-4254.2024.11.22

J Hu, F DU, L Ding, L Wang, W Zhao

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Abstract

Objective: To analyze the factors affecting the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B-associated cirrhosis (CHB-Cir) complicated by essential hypertension (EH) and explore the impact of EH on HCC risk in patients with CHB-Cir.

Methods: This study was conducted among the patients with CHB-Cir with or without EH received antiviral therapy in the Infectious Disease Department, Third Affiliated Hospital of Xinxiang Medical University from January, 2017 to January, 2024. The cases with insufficient follow-up time or missing data were excluded. The patients were subjected to propensity score matching in a 1:1 ratio to form an EH group and a non-EH group. The Kaplan-Meier method was used to compare the cumulative incidence of HCC between the two groups, and the Cox proportional hazards regression model was used to analyze the risk of HCC and the factors affecting HCC risk.

Results: A total of 390 CHB-Cir patients (274 male and 116 female patients) were enrolled in this study, including 195 with EH and 195 without EH. In these patients, EH was significantly correlated with the occurrence of HCC (HR=1.69, P=0.002). Multivariate analysis suggested that the male gender (HR=1.73, P=0.005), a family history of liver cancer (HR=2.23, P < 0.001), elevated alpha-fetoprotein (HR=2.83, P=0.001), elevated glutathione reductase (HR=1.53, P=0.046), reduced high-density lipoprotein (HR=1.46, P=0.027), and elevated low-density lipoprotein (HR=2.29, P=0.003) were all significantly correlated with HCC occurrence, while elevated triglycerides (HR= 0.37, P < 0.001) was a protective factor against HCC. In the EH group, treatment with non-RASIs drugs (HR=2.77, P=0.021) and no treatment/diuretic treatment (HR=7.18, P < 0.001) were significantly correlated with HCC occurrence.

Conclusion: Hypertension increases the risk of HCC in patients with CHB-Cir, suggesting the importance of controlling hypertension in these patients.

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[乙型肝炎相关肝硬化和高血压患者肝细胞癌的风险评估：基于倾向评分匹配的回顾性队列研究]。

目的：分析慢性乙型肝炎相关肝硬化（CHB-Cir）合并原发性高血压（EH）患者发生肝细胞癌（HCC）风险的影响因素，探讨EH对CHB-Cir患者发生HCC风险的影响。方法：选取2017年1月至2024年1月在新乡医科大学第三附属医院感染性疾病科接受抗病毒治疗的合并或不合并EH的CHB-Cir患者为研究对象。排除随访时间不足或资料缺失的病例。将患者按1:1的比例进行倾向评分匹配，分为EH组和非EH组。采用Kaplan-Meier法比较两组HCC累积发病率，采用Cox比例风险回归模型分析HCC发生风险及影响HCC发生风险的因素。结果：共纳入390例CHB-Cir患者（男性274例，女性116例），其中合并EH 195例，未合并EH 195例。在这些患者中，EH与HCC的发生显著相关（HR=1.69， P=0.002）。多因素分析显示，男性（HR=1.73， P=0.005）、肝癌家族史（HR=2.23, P < 0.001）、甲胎蛋白升高（HR=2.83， P=0.001）、谷胱甘肽还原酶升高（HR=1.53， P=0.046）、高密度脂蛋白降低（HR=1.46， P=0.027）、低密度脂蛋白升高（HR=2.29， P=0.003）与HCC发生有显著相关性，甘油三酯升高（HR= 0.37, P < 0.001）是HCC发生的保护因素。在EH组中，非rasis药物治疗（HR=2.77， P=0.021）和未治疗/利尿剂治疗（HR=7.18, P < 0.001）与HCC发生显著相关。结论：高血压可增加CHB-Cir患者发生HCC的风险，提示控制高血压在CHB-Cir患者中的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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