| 特集名 | 肝疾患の予後 | |
|---|---|---|
| 題名 | ウイルス性肝硬変の予後 --B型とC型 | |
| 発刊年月 | 1997年 10月 | |
| 著者 | 林 直諒 | 東京女子医科大学消化器内科 |
| 【 要旨 】 | 1987年以降の肝硬変の予後に関する報告14編について検討した．成因の区別なく集計した5年累積生存率は，中央値で62%であったが，1989年までと1990年以降の報告を比較すると，データ上，5年累積生存率は55%から70%へと改善した． B型とC型の生存率の比較では，10年までは差はなく，それ以降ではB型が横ばいとなるのに対して，C型ではそれ以降も直線的に低下する傾向が認められている．この傾向は肝細胞癌の発癌率についても認められ，B型肝硬変では10年以降は累積発癌率は横ばいとなるが，C型では10年以降も一定の率で発癌するものと推定される．少数の報告ではあるが，B型とC型の重複感染例の予後は単独感染例に比べ不良であった． |
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| Theme | Prognosis of Liver Diseases | |
|---|---|---|
| Title | Prognosis of Patients with Cirrhosis due to Hepatitis Virus -- Hepatitis B and Hepatitis C | |
| Author | Naoaki Hayashi | Division of Medicine, Institute of Gastroenterology, Tokyo Women's Medical College |
| [ Summary ] | We studied 16 reports concerning the prognosis associated with cirrhosis after 1987. Although the median 5-year survival rate of cirrhosis patients was 62% regardless of the etiology, it improved from 55% before 1989 to 70% after 1990. We compared the survival rate between cirrhosis due to hepatitis B (type B) and cirrhosis due to hepatitis C(type C). Although there was no difference up to 10 years, the survival rate with type B cirrhosis did not decrease significantly whereas that associated with type C cirrhosis continued to decrease as a constant rate after 10 years. This tendency was also seen in the developement rate of hepatocellular carcinoma (HCC), and it is speculated that HCC develops from type C cirrhosis at a constant rate even after 10 years. The prognosis of cirrhotic patients, who are positive for both hepatitis B virus and hepatitis C virus, is worse than that of those who are positive for only one of these viral genomes although there are only a few reports concerning this issue. |
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