{"id":89,"date":"2014-10-15T11:57:22","date_gmt":"2014-10-15T02:57:22","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=89"},"modified":"2015-08-06T11:57:50","modified_gmt":"2015-08-06T02:57:50","slug":"%e6%85%a2%e6%80%a7%e8%82%9d%e7%82%8e%e3%81%ae%e8%82%9d%e7%b4%b0%e8%83%9e%e3%82%b9%e3%82%af%e3%83%aa%e3%83%bc%e3%83%8b%e3%83%b3%e3%82%b0%e3%80%80%e3%82%b7%e3%82%b9%e3%83%86%e3%83%9e%e3%83%81%e3%83%83","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=89","title":{"rendered":"\u6162\u6027\u809d\u708e\u306e\u809d\u7d30\u80de\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3000\u30b7\u30b9\u30c6\u30de\u30c1\u30c3\u30af\u30ec\u30d3\u30e5\u30fc"},"content":{"rendered":"

\u2015\u6587\u732e\u540d\u2015
\nDevan Kansagara, MD et al. Screening for Hepatocellular Carcinoma in Chronic Liver Disease\u3000A Systematic Review<\/p>\n

\u2015\u8981\u7d04\u2015
\n\u3010Background\u3011
\n\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u306f\u30cf\u30a4\u30ea\u30b9\u30af\u60a3\u8005\u306e\u809d\u7d30\u80de\u764c\u306e\u5b9a\u671f\u7684\u306a\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3092\u63a8\u5968\u3057\u3066\u3044\u308b\u304c\u3001\u305d\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u30ec\u30d9\u30eb\u306f\u4e0d\u900f\u660e\u3067\u3042\u308b\u3002<\/p>\n

\u3010Purpose\u3011
\n\u6162\u6027\u809d\u708e\u60a3\u8005\u306eHCC\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3064\u3044\u3066\u306e\u6709\u76ca\u6027\u3068\u6709\u5bb3\u6027\u306b\u3064\u3044\u3066\u30ec\u30d3\u30e5\u30fc\u3059\u308b\u3053\u3068\u3002<\/p>\n

\u3010Data Sources\u3011
\nMEDLINE, PsycINFO, and ClinicalTrials.gov \u306b\u95a2\u3057\u3066\u306f\u691c\u7d22\u53ef\u80fd\u306a\u6642\u671f\u304b\u30892014\u5e744\u6708\u307e\u3067
\nCochrane databases\u306b\u95a2\u3057\u3066\u306f\u691c\u7d22\u53ef\u80fd\u306a\u6642\u671f\u304b\u30892013\u5e746\u6708\u307e\u3067<\/p>\n

\u3010Study Selection\u3011\u00a0
\n\u82f1\u8a9e\u306e\u7814\u7a76\u3067\u89b3\u5bdf\u7814\u7a76\u3001\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u7fa4\u3068\u975e\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u7fa4\u306e\u6bd4\u8f03\u7814\u7a76\u3001\u6709\u5bb3\u4e8b\u8c61\u306e\u7814\u7a76\u3001\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u306e\u9593\u9694\u306b\u95a2\u3059\u308b\u6bd4\u8f03\u7814\u7a76<\/p>\n

\u3010Data Extraction\u3011
\n\u6700\u3082\u91cd\u8996\u3057\u305f\u3082\u306e\u306f\u6b7b\u4ea1\u3068\u6709\u5bb3\u4e8b\u8c61\u3067\u3042\u308b\u3002
\n\u500b\u3005\u306e\u7814\u7a76\u306e\u8cea\u3068\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u5f37\u3055\u3092\u30d1\u30d6\u30ea\u30c3\u30b7\u30e5\u3055\u308c\u3066\u3044\u308b\u30af\u30e9\u30a4\u30c6\u30ea\u30a2\uff08\u6587\u732e16\u53c2\u7167\uff09\u3092\u7528\u3044\u30662\u4eba\u3067\u30ec\u30d3\u30e5\u30fc\u3057\u305f\u3002<\/p>\n

\u3010Data Synthesis\u3011
\n13,801\u304b\u308922\u306e\u7814\u7a76\u304cinclusion\u3055\u308c\u305f\u3002
\n\u7dcf\u3058\u3066\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u306e\u52b9\u679c\u306b\u304a\u3051\u308b\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u975e\u5e38\u306b\u4f4e\u304b\u3063\u305f\u3002
\n\u4e00\u3064\u306e\u5927\u898f\u6a21\u7814\u7a76\u3067\u5b9a\u671f\u7684\u306a\u8d85\u97f3\u6ce2\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u306b\u304a\u3051\u308bHCC\u6b7b\u4ea1\u7387\u304c\u4f4e\u3044\u7d50\u679c\u3067\u3042\u3063\u305f\u3002 (83.2 vs. 131.5 per 100,000 person-years \uff1brate ratio, 0.63 [95% CI, 0.41 to 0.98])\u3000\u3057\u304b\u3057\u3001\u3053\u306e\u7814\u7a76\u3067\u306f\u65b9\u6cd5\u8ad6\u7684\u9650\u754c\u304c\u3042\u3063\u305f\u3002\uff08baseline characteristics\u304c\u4e0d\u900f\u660e\u3001\u30e9\u30f3\u30c0\u30e0\u5316\u4f5c\u696d\u304c\u4e0d\u900f\u660e\u3001\u6b7b\u4ea1\u306e\u307f\u304c\u30a2\u30a6\u30c8\u30ab\u30e0\u3067\u3042\u308a\u8ffd\u8de1\u7387\u306b\u5dee\u304c\u3042\u308b\u306a\u3069\u306e\u554f\u984c\u3042\u308a\uff09
\n\u4ed6\u306e\u7814\u7a76\u3067\u306fB\u578b\u809d\u708e\u60a3\u8005\u306e\u5b9a\u671f\u7684\u306aAFP\u691c\u67fb\u3067\u751f\u5b58\u306b\u95a2\u3059\u308b\u6709\u76ca\u6027\u306f\u8a8d\u3081\u306a\u304b\u3063\u305f\u3002\u5168\u6b7b\u4ea1\uff0f100\u4eba\u5e74\u304c1.84 vs 1.79 (P=NS)\u3067\u3042\u3063\u305f\u3002
\n18\u500b\u306e\u89b3\u5bdf\u7814\u7a76\u3067\u306fHCC\u306e\u8a3a\u65ad\u306b\u81f3\u3063\u305f\u6bb5\u968e\u3067\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3055\u308c\u3066\u3044\u305f\u60a3\u8005\u7fa4\u3067\u306f\u3001\u81e8\u5e8a\u7684\u306b\u8a3a\u65ad\u3055\u308c\u305f\u7fa4\u3088\u308a\u3082\u65e9\u671f\u306e\u30b9\u30c6\u30fc\u30b8\u3067\u3042\u3063\u305f\u3002\u3057\u304b\u3057\u3001\u30ea\u30fc\u30c9\u30bf\u30a4\u30e0\u30fb\u30d0\u30a4\u30a2\u30b9\u3001\u30ec\u30f3\u30b0\u30b9\u30bf\u30a4\u30e0\u30fb\u30d0\u30a4\u30a2\u30b9\u304c\u4ea4\u7d61\u3057\u3066\u3044\u305f\u3002
\n2\u3064\u306e\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u306e\u9593\u9694\u306b\u95a2\u3059\u308b\u7814\u7a76\u3067\u306f\u3001\u77ed\u3044\u9593\u9694\uff083\uff5e4\u304b\u6708\uff09\u3068\u9577\u3044\u9593\u9694\uff086\uff5e12\u304b\u6708\uff09\u3067\u751f\u5b58\u7387\u306b\u5dee\u304c\u51fa\u306a\u304b\u3063\u305f\u3002
\n\u6709\u5bb3\u4e8b\u8c61\u306b\u95a2\u3057\u3066\u306f\u826f\u8cea\u306a\u7814\u7a76\u304c\u306a\u304b\u3063\u305f\u3002\uff08\u78ba\u8a3c\u7684\u691c\u67fb\u3067\u3042\u308bCT\u3001MRI\u3001\u809d\u751f\u691c\u306e\u30ea\u30b9\u30af\u3092\u6271\u3063\u305f\u3082\u306e\u306f\u3042\u3063\u305f\u3002\uff09<\/p>\n

\u3010Limitations\u3011\u00a0
\n\u82f1\u8a9e\u7814\u7a76\u306e\u307f\u3067\u3042\u3063\u305f\u3053\u3068\u3002\u3053\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u65b9\u6cd5\u8ad6\u7684\u306a\u554f\u984c\u3068\u7814\u7a76\u6570\u304c\u5c11\u306a\u3044\u3053\u3068\u3067\u7814\u7a76\u9650\u754c\u304c\u3042\u3063\u305f\u3002<\/p>\n

\u3010Conclusion\u3011
\n\u6162\u6027\u809d\u708e\u60a3\u8005\u306eHCC\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u306b\u3088\u308b\u6b7b\u4ea1\u7387\u306b\u5bfe\u3059\u308b\u52b9\u679c\u306f\u975e\u5e38\u306b\u5f31\u3044\u30a8\u30d3\u30c7\u30f3\u30b9\u3057\u304b\u306a\u304b\u3063\u305f\u3002
\n\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u306f\u65e9\u671f\u809d\u7d30\u80de\u764c\u3092\u540c\u5b9a\u3067\u304d\u308b\u53ef\u80fd\u6027\u306f\u3042\u308b\u304c\u3001\u73fe\u6bb5\u968e\u3067\u306f\u81e8\u5e8a\u7684\u306a\u8a3a\u65ad\u3088\u308a\u3082\u30b7\u30b9\u30c6\u30e0\u5316\u3055\u308c\u305f\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u304c\u751f\u5b58\u306e\u4e0a\u3067\u6709\u5229\u304b\u3069\u3046\u304b\u306f\u5b9a\u304b\u3067\u306f\u306a\u3044\u3002<\/p>\n

\uff1c\u53c2\u8003\u2460\uff1e
\n\uff08lead time bias\uff09
\n\u691c\u8a3a\u767a\u898b\u304c\u3093\u3068\u5916\u6765\u767a\u898b\u304c\u3093\u3068\u306e\u9593\u3067\u751f\u5b58\u7387\u3092\u6bd4\u8f03\u3059\u308b\u969b\u306b\u554f\u984c\u3068\u306a\u308b\u504f\u308a\u3002\u304c\u3093\u306e\u767a\u751f\u304b\u3089\u6b7b\u4ea1\u307e\u3067\u306e\u6642\u9593\u304c\u691c\u8a3a\u767a\u898b\u7fa4\u3068\u5916\u6765\u767a\u898b\u7fa4\u306e\u4e21\u7fa4\u3067\u7b49\u3057\u3044\uff08\u3059\u306a\u308f\u3061\u691c\u8a3a\u306e\u52b9\u679c\u304c\u306a\u3044\uff09\u5834\u5408\u3067\u3082\u3001\u691c\u8a3a\u3067\u65e9\u671f\u8a3a\u65ad\u3055\u308c\u305f\u6642\u9593\u306e\u5206\uff08\u30ea\u30fc\u30c9\u30bf\u30a4\u30e0\uff09\u3060\u3051\u3001\u691c\u8a3a\u767a\u898b\u304c\u3093\u60a3\u8005\u306e\u751f\u5b58\u6642\u9593\u306f\u898b\u304b\u3051\u4e0a\u9577\u3044\u3053\u3068\u306b\u306a\u308a\u3001\u3057\u305f\u304c\u3063\u3066\u898b\u304b\u3051\u4e0a\u306e\u751f\u5b58\u7387\u3082\u4e0a\u304c\u308b\u3053\u3068\u306b\u306a\u308b\u3068\u3044\u3046\u504f\u308a\u3002\u751f\u5b58\u671f\u9593\u306e\u59cb\u70b9\u304c\u65e9\u671f\u767a\u898b\u306e\u5206\u3060\u3051\u305a\u308c\u308b\u3068\u3044\u3046\u610f\u5473\u304b\u3089\u3001\u30bc\u30ed\u30bf\u30a4\u30e0\u30fb\u30b7\u30d5\u30c8\u3068\u3082\u547c\u3070\u308c\u308b\u3002<\/p>\n

\uff08length time bias\uff09
\n\u3000\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3067\u8a3a\u65ad\u3055\u308c\u308b\u75be\u60a3\u306f\u3001\u901a\u5e38\u306e\u8a3a\u7642\u3067\u8a3a\u65ad\u3055\u308c\u308b\u5834\u5408\u3088\u308a\u3082\u7de9\u5f90\u306b\u9032\u884c\u3059\u308b\u75c5\u5909\u304c\u591a\u3044\u304b\u3082\u3057\u308c\u306a\u3044\u3002\u3068\u3044\u3046\u306e\u3082\u3001\u9032\u884c\u304c\u901f\u3044\u75c5\u5909\u306f\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u53d7\u3051\u308b\u9593\u3082\u306a\u304f\u3001\u75c7\u72b6\u304c\u9855\u5728\u5316\u3057\u53d7\u8a3a\u3057\u3066\u75c5\u5909\u3092\u767a\u898b\u3055\u308c\u308b\u3053\u3068\u306b\u306a\u308b\u3002\u7de9\u5f90\u9032\u884c\u6027\u306e\u75c5\u5909\u306f\u9577\u304f\u4f53\u5185\u306b\u75c5\u5909\u304c\u5b58\u5728\u3057\u3066\u3044\u308b\u306e\u3067\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3067\u767a\u898b\u3055\u308c\u3084\u3059\u3044\u3002\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u304c\u5b9f\u969b\u3088\u308a\u3082\u6709\u52b9\u3067\u3042\u308b\u3088\u3046\u306b\u898b\u3048\u3066\u3057\u307e\u3046\u3002<\/p>\n

\uff1c\u53c2\u8003\u2461\uff1e
\nAASLD\u7c73\u56fd\u809d\u81d3\u75c5\u5b66\u4f1a\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3
\nrecommendation…\u534a\u5e74\u3054\u3068\u306e\u8179\u90e8\u30a8\u30b3\u30fc\uff081\u5e74\u6bce\u3067\u306f\u306a\u304f\uff09
\n\u3000\u3000\u3000\u671f\u9593\u3068\u3057\u30663\u30ab\u6708\u30686\u304b\u6708\u3067\u3069\u3046\u9055\u3046\u304b\uff1f
\n\u3000\u3000\u3000\u5c40\u6240\u75c5\u5909\u306e\u691c\u51fa\u306b\u5dee\u306a\u3057
\n10\u339c\u4ee5\u4e0b\u306e\u75c5\u5909\u306e\u691c\u51fa\u7387\u306f3\u30ab\u6708\u3067\u6709\u5229\u3060\u304c\u3001
\nHCC\u767a\u751f\u7d2f\u7a4d\u6570\u3001\u4ee3\u511f\u4e0d\u5168\u3001\u809d\u79fb\u690d\u3001\u751f\u5b58\u7387\u306b\u95a2\u3057\u3066\u5dee\u306a\u3057
\nnot recommend…
\n\u8179\u90e8\u30a8\u30b3\u30fc\u3068AFP\u306e\u7d44\u307f\u5408\u308f\u305b\uff08\u30b3\u30b9\u30c8\u9ad8\u3068\u7591\u967d\u6027\u2191\uff09
\n\u3000\u3000\u3000AFP\u5358\u72ec\uff08\u611f\u5ea6\u3001\u7279\u7570\u5ea6\u304c\u4f4e\u3044\uff09
\n\u3000\u3000\u3000CT\uff08\u7591\u967d\u6027\u2191\u3001\u30b3\u30b9\u30c8\u9ad8\u3001\u653e\u5c04\u7dda\u91cf\u306e\u554f\u984c\uff09<\/p>\n

\uff1c\u65e5\u672c\u764c\u6cbb\u7642\u5b66\u4f1a\uff1e\u3000http:\/\/jsco-cpg.jp\/item\/02\/intro_03.html<\/p>\n

\u3010\u958b\u50ac\u65e5\u3011
\n2014\u5e7410\u670815\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\u2015\u6587\u732e\u540d\u2015 Devan Kansagara, MD et al. Screening for Hepatocellular Carcinoma in Chronic Liver Disease\u3000A Systematic … \u7d9a\u304d\u3092\u8aad\u3080 \u6162\u6027\u809d\u708e\u306e\u809d\u7d30\u80de\u30b9\u30af\u30ea\u30fc\u30cb\u30f3\u30b0\u3000\u30b7\u30b9\u30c6\u30de\u30c1\u30c3\u30af\u30ec\u30d3\u30e5\u30fc<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[17],"tags":[],"class_list":["post-89","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/89","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=89"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/89\/revisions"}],"predecessor-version":[{"id":90,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/89\/revisions\/90"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=89"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=89"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=89"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}