Kenji Ikeda1. 1. Department of Hepatology, Toranomon Hospital, Tokyo, Japan.
Abstract
AIM: There is no useful and effective treatment for patients with non-sustained response to interferon, from the viewpoint of cancer prevention. Our aim was to elucidate the influence of a glycyrrhizin therapy on hepatocarcinogenesis rate in interferon-resistant hepatitis C Methods: We retrospectively analyzed 1249 patients with chronic hepatitis with or without cirrhosis. Among 346 patients with high alanine transaminase values of twice or more of the upper limit of normal, 244 patients received i.v. glycyrrhizin injection and 102 patients did not, after judgment of interferon resistance. RESULTS: Crude carcinogenesis rates in the treated and untreated group were 13.3%, 26.0% at the fifth year, and 21.5% and 35.5% at the 10th year, respectively (P = 0.021). Proportional hazard analysis using time-dependent covariates disclosed that fibrotic stage, gender and glycyrrhizin treatmentwere significantly associated with future carcinogenesis. A long-term glycyrrhizin injection therapy decreased the hepatocarcinogenesis rate (hazard ratio, 0.49; 95% confidence interval, 0.27-0.86, P = 0.014) after adjusting the background features with significant covariates. Cancer preventive activity was also found in a subgroup of older patients of 60 years or more. CONCLUSIONS: Glycyrrhizin injection therapy significantly decreased the incidence of hepatocellular carcinoma in patients with interferon-resistant active chronic hepatitis C, whose average aminotransferase value was twice or more of the upper limit of normal after interferon.
AIM: There is no useful and effective treatment for patients with non-sustained response to interferon, from the viewpoint of cancer prevention. Our aim was to elucidate the influence of a glycyrrhizin therapy on hepatocarcinogenesis rate in interferon-resistant hepatitis C Methods: We retrospectively analyzed 1249 patients with chronic hepatitis with or without cirrhosis. Among 346 patients with high alanine transaminase values of twice or more of the upper limit of normal, 244 patients received i.v. glycyrrhizin injection and 102 patients did not, after judgment of interferon resistance. RESULTS: Crude carcinogenesis rates in the treated and untreated group were 13.3%, 26.0% at the fifth year, and 21.5% and 35.5% at the 10th year, respectively (P = 0.021). Proportional hazard analysis using time-dependent covariates disclosed that fibrotic stage, gender and glycyrrhizin treatmentwere significantly associated with future carcinogenesis. A long-term glycyrrhizin injection therapy decreased the hepatocarcinogenesis rate (hazard ratio, 0.49; 95% confidence interval, 0.27-0.86, P = 0.014) after adjusting the background features with significant covariates. Cancer preventive activity was also found in a subgroup of older patients of 60 years or more. CONCLUSIONS:Glycyrrhizin injection therapy significantly decreased the incidence of hepatocellular carcinoma in patients with interferon-resistant active chronic hepatitis C, whose average aminotransferase value was twice or more of the upper limit of normal after interferon.