| [ Summary ] |
In order to elucidate the influence of the long-term administration of interferon on the appearance rates of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV)-related cirrhosis, we analyzed 313 consecutive patients with cirrhosis. Among the 313 patients, 94 underwent long-term intermittent administration of interferon for 6 months or more, and the other 219 patients received no anti-viral drugs. Cumulative appearance rates of HCC in the interferon and the untreated group were 4.5%, 13.3% respectively at the end of the third year, 7.0%, 19.6% respectively at the end of the fifth year, and 17.0% and 30.8% at the end of the 10th year. The HCC development rate in the treated group was significantly lower than that of the untreated group (p=0.0124). The proportional hazard model revealed that interferon treatment was an independent contributing factor in lowering the rate of carcinogenesis (Odds ratio=0.39, p=0.031) even after correction by significant covariates in multivariate analysis. The virological study showed that the role of interferon therapy, from the viewpoint of cancer prevention, was much larger in patients with higher HBV-DNA concentrations (10Meq or more). Interferon therapy for HBV-related cirrhosis significantly decreased the HCC appearance rate, especially in patients with a higher amounts of serum HBV-DNA. If interferon is properly administered to a selected group of patients, an effective strategy for cancer prevention may be achieved, even in patients with cirrhosis. |