美國肝病研究學會 2017 年肝臟年會受邀演講 報告

出國報告（出國類別：國際會議）

美國肝病研究學會 2017 年肝臟年會受邀演講 報告

服務機關：臺中榮民總醫院 姓名職稱：李騰裕主治醫師 派赴國家：美國

出國期間：106.10.18-106.10.26 報告日期：106.12.29

摘要（含關鍵字）

關鍵字：阿斯匹靈、慢性 B 型肝炎、肝細胞癌。

本次受邀美國肝病研究學會 2017 年肝臟年會(The Liver Meeting 2017 of The American Association for the Study of Liver Diseases [AASLD])上台口頭報告，演講題目為“阿斯匹 靈減少慢性 B 型肝炎患者發生肝細胞癌的相關性研究”。摘要如下：Hepatitis B virus (HBV)-related liver cancer is a major public health issue with a severe socioeconomic impact.

An estimated 240 million people worldwide have chronic HBV, with the prevalence highest in Africa and Asia. Death from HBV is commonly due to the development of cirrhosis or hepatocellular carcinoma (HCC). Multiple clinical studies have demonstrated a link between long-term aspirin use and a reduction in the incidence and mortality of several cancer types, including colorectal, stomach, esophageal, breast, lung, prostate, and liver cancer. Research has also demonstrated that aspirin can reduce cancer risk, particularly in the presentation of colorectal cancer. In this study, we retrieved medical records from the National Health

Insurance Research Database in Taiwan between 1998 and 2012 and screened the records of 204,507 patients with chronic hepatitis B. They excluded patients who had other forms of infectious hepatitis and who already had been diagnosed with HCC. A cohort of 1,553 patients who had continuously received daily aspirin for at least 90 days were randomly matched 1:4 with 6,212 patients who had never received anti-platelet therapy, using propensity scores consisting of baseline characteristics, the index date and nucleos(t)ide analogue use during follow-up. Patients who received aspirin had a lower HCC incidence than the non-aspirin group in five years (2.86% vs. 5.59%; P<0.01). In a multivariable regression analysis, aspirin therapy was independently associated with a reduced HCC risk (HR 0.63; P= 0.002). Sensitivity subgroup analyses also verified this association. Older age, male gender, cirrhosis and diabetes were also independently associated with an increased risk, and nucleos(t)ide analogue or statin use was associated with a decreased risk. Patients who received aspirin were at an increased risk of peptic ulcer disease. 美國肝病研究學會的肝臟 年會是全世界最高水準的學術發表會議，能夠受邀口頭報告是肝病研究領域很大的榮譽，

也算某種型式的為國爭光。在準備及上台口頭英語報告的過程中，學習到許多重要的經 驗，也交到許多重要的國際友人。本次演講內容受大會重視，除了大會官方媒體，也發 布於數個平面及電子媒體，例如 Bottom Line Personal, Gastroenterology & Hepatology News, MD magazine 等。顯示研究主題為重要的臨床議題，值得進一步研究發展。

目次

一、目的

二、過程

三、心得

四、建議事項

本文

一、 目的：

二、 過程：

Hepatitis B virus (HBV)-related liver cancer is a major public health issue with a severe socioeconomic impact. An estimated 240 million people worldwide have chronic HBV, with the prevalence highest in Africa and Asia. Death from HBV is commonly due to the development of cirrhosis or hepatocellular carcinoma (HCC). Multiple clinical studies have demonstrated a link between long-term aspirin use and a reduction in the incidence and mortality of several cancer types, including colorectal, stomach, esophageal, breast, lung, prostate, and liver cancer. Research has also demonstrated that aspirin can reduce cancer risk, particularly in the presentation of colorectal cancer. In this study, we retrieved medical records from the National Health Insurance Research Database in Taiwan between 1998 and 2012 and screened the records of 204,507 patients with chronic hepatitis B. They excluded

patients who had other forms of infectious hepatitis and who already had been diagnosed with HCC. A cohort of 1,553 patients who had continuously received daily aspirin for at least 90 days were randomly matched 1:4 with 6,212 patients who had never received anti-platelet therapy, using propensity scores consisting of baseline characteristics, the index date and nucleos(t)ide analogue use during follow-up. Patients who received aspirin had a lower HCC incidence than the non-aspirin group in five years (2.86% vs. 5.59%; P<0.01). In a multivariable regression analysis, aspirin therapy was independently associated with a reduced HCC risk (HR 0.63; P= 0.002). Sensitivity subgroup analyses also verified this association. Older age, male gender, cirrhosis and diabetes were also independently associated with an increased risk, and nucleos(t)ide analogue or statin use was associated with a decreased risk. Patients who received aspirin were at an increased risk of peptic ulcer disease. We conclude that aspirin therapy was significantly associated with a reduced incidence of HCC in patients with chronic hepatitis B. Aspirin therapy was independently associated with a reduced HCC risk (HR 0.63). Our findings may be of help to further improve the chemoprevention of HBV-related HCC. However, a proof-of-concept trial of aspirin chemoprevention for HBV-related HCC is needed.

一、 心得

美國肝病研究學會的肝臟年會是全世界最高水準的學術發表會議，能夠受邀口頭報告是 肝病研究領域很大的榮譽，也算某種型式的為國爭光。在準備及上台口頭英語報告的過 程中，學習到許多重要的經驗，也交到許多重要的國際友人。本次演講內容受大會重視，

除了大會官方 媒體，也發布於 數個平面 及電子 媒體，例如 Bottom Line Personal, Gastroenterology & Hepatology News, MD magazine 等。顯示這個研究主題為重要的臨床 議題，值得進一步研究發展。目前相關後續研究，包括臨床及動物實驗，目前已進行申 請科技部研究計畫中。

四、 建議事項（包括改進作法）

院方可增加各種獎勵方式多鼓勵於國際發表學術研究，特別是於國際一流的重要會議口 頭發表，可為本院、甚至台灣增加曝光發言的機會；也可促進國際交流，增加英語報告 的經驗及能力，提升本院研究人員的水準。

附錄：無