与韩国学者这篇文章同期发布的还有一篇由加拿大皇后大学Jennifer A. Flemming博士和美国加利福尼亚大学Norah A. Terrault博士共同署名的评论文章[9](Tenofovir vs Entecavir for Hepatocellular Carcinoma Prevention in Patients With Chronic Hepatitis B - One of These Things Is Not Like the Other)。文章中指出,迄今为止,除了在失代偿期肝硬化人群中以外,并没有其他直接的头对头随机化试验来比较ETV和TDF。在特定临床情况下或亚组人群中,一种药是否优于另外一种药?“在缺少随机化比较研究的情况下,高质量的真实世界队列可提供大量信息”。在这项研究中,TDF治疗人群的HCC风险比ETV治疗人群低大约35%,在按肝硬化状况分层以及对其他多种混杂因子校正后,这一关系仍然存在。按照韩国研究的结果,若要有足够的统计学效力检测出HCC风险降低35%,HCC例数至少要达到200例,而过去许多研究达不到这个标准。
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