C肝患者罹癌機率 6指標可預知

[Sidney]

【聯合報╱記者劉惠敏／台北報導】 2012.02.20 08:39 am


台灣Ｃ型肝炎患者約五十萬人，中央研究院團隊透過長期追蹤，從年齡、是否肝硬化及肝功能指數等六項指標，預測患者未來十年、十五年罹患肝癌的機率，準確度高達八成。Ｃ肝患者可參考檢驗報告自行試算。

中研院院士陳建仁帶領的研究團隊，於亞太肝臟研究學會國際會議發表此研究結果，中研院博士後研究員李美璇因此獲頒青年學者獎。不過，此預測模式僅適用於卅歲以上亞洲人，台灣肝病學會計畫建置自我檢測網站、智慧型手機程式，供民眾使用。

預測Ｃ肝患者未來罹患肝癌機率的指標中，血清指標占很重要地位，包括Ｃ肝病毒核醣核酸（ＲＮＡ）濃度、病毒基因型、肝功能指數、肝功能指數比值；另兩項指標則是年紀、有無肝硬化。

六項指標各有分數，總分從最低零分到最高廿五分，罹癌風險隨分數增加上升。若為廿五分，十年及十五年罹癌率高達八成三及九成九（詳見附表）。
陳建仁舉例，張三今年五十三歲，肝功能指數八十、肝功能指數比值二、有肝硬化，ＲＮＡ濃度高且基因型為第一型者，總分為廿三分，十年後罹癌風險約六成一，十五年更高達九成。

Ｃ肝病毒基因共有六型，台灣以第一、二型患者居多。陳建仁說，第一型患者罹患肝癌風險最高；四十五歲以上或有肝硬化的Ｃ肝患者，罹癌風險也加倍。
陳建仁說，國內肝癌患者，七至七成五由Ｂ肝引起，Ｃ肝則占二至二成五。Ｂ、Ｃ肝患者終其一生罹患肝癌的機率約二成五，若合併兩種肝炎，罹癌機率則高達六成。

台大臨床醫學研究所教授陳培哲提醒，Ｂ、Ｃ肝炎主要感染途徑都是血液感染，Ｂ肝可被治療、控制，目前也可施打疫苗預防，Ｃ肝則無疫苗，但有可能治癒。預防肝癌首要是降低罹患肝炎風險，避免不當使用針頭等血液傳播病毒行為，定期健檢確定是否感染肝炎，肝炎患者需定期追蹤，並積極治療。

[billwin.tw]

是由先前的文章持續追蹤之後

http://jco.ascopubs.org/content/28/30/4587.long

整理出公式嗎 ?

[wipten]

若預測失準 研發者沒事 醫師負責賠錢

[reagan]

值得參考

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