68. 依據 2023 AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma，下列何者敘述正確？
(1) AASLD advises against the combination of systemic therapy with
transarterial therapies for BCLC Stage B HCC outside of a clinical trial setting
(2) Patients with BCLC Stage B HCC should be treated with transarterial
chemoembolization
(3) AASLD advises radioembolization as an alternative therapy to
chemoembolization in patients with BCLC Stage B HCC
(4) Patients with Child-Turcotte-Pugh class C cirrhosis should be enrolled in
surveillance programs
(A) (3)＋(4)
(B) (1)＋(2)
(C) (3)
(D) (1)＋(2)＋(3)

(E) (1)＋(2)＋(3)＋(4)

64. 以 Glucocorticoids 來治療酒精性肝炎之敘述何者為正確？(1) Glucocorticoids 可用於不同嚴重程度之酒精性肝炎(2) 有消化道出血或活動性感染時，避免使用(3) 因酒精性肝炎所導致之 hepatorenal syndrome 並無顯著療效(4) 對 discriminant function ＞ 32 者較有助益(5) 對 spontaneous hepatic encephalopathy 者較有助益(A) (1)＋(3)＋(4)(B) (2)＋(3)＋(4)(C) (2)＋(4)＋(5)(D) (2)＋(4)(E) (2)＋(3)＋(4)＋(5)

65. 目前使用口服抗 B 型肝炎藥物，若要考慮停藥，除了 e 抗原陰轉外，以下何者是 現階段停藥的最佳 Biomarker？ (A) HBsAg 定量＞ 100 IU/mL (B) HBsAg 定量＜ 100 IU/mL (C) HBV DNA ＜ 2000 IU/mL (D) HBcrAg ＜ 4 log (E) HBcrAg ＜ 3 Log

66. HCC systemic therapy，依據 phase 3 clinical trials 的結果，其 overall survival相對於 sorafenib 的 HR(hazard ratio)，由小至大排列順序，何者正確？(1) IMbrave 150, Atezolizumab + Bevacizumab(2) HIMALAYA, STRIDE: Tremelimumab + Durvalumab(3) COSMIC-312, Cabozantinib + Atezolizumab(4) CARES-310, Camrelizumab + Rivoceranib(A) (1)—(2)—(4)—(3)(B) (1)—(4)—(2)—(3)(C) (2)—(1)—(3)—(4)(D) (4)—(2)—(1)—(3)(E) (4)—(1)—(2)—(3)

67. 關於中期肝癌 TACE unsuitable 的範圍，2020 APPLE Expert Consensus Statement 與 2023 AASLD Practice Guidance 比較，其中包括下列何種共同項目？(1) ＞ 50% liver involvement(2) Infiltrative type(3) Bilobar extensive HCC(4) Extranodular growth type HCC(5) Poorly differentiated HCC(A) (2)＋(3)(B) (1)＋(2)＋(3)(C) (2)＋(3)＋(4)＋(5)(D) (2)＋(3)＋(5)(E) (1)＋(2)＋(3)＋(4)＋(5)

69. 依據 2023 AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma，下列何者敘述正確？(1) AASLD does not advise use of statins, aspirin, and metformin solely toreduce HCC risk(2) AASLD recommends against routine use of HCC surveillance in patientswith NAFLD who have advanced fibrosis but without cirrhosis(3) AASLD advises repeat short-interval ultrasound and AFP in approximately3-6 months for patients with a ＜1 cm lesion on abdominal ultrasound(4) In patients with an LI-RADS-4 observation, AASLD advises repeatcross-sectional imaging in 3–6 months(A) (3)＋(4)(B) (1)＋(2)(C) (3)(D) (1)＋(2)＋(3)(E) (1)＋(2)＋(3)＋(4)

70. 依據 2023 AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma，下列何者敘述正確？(1) Patients with HCC beyond BCLC Stage 0 should undergo non-contrast CTof the chest to evaluate for metastatic disease(2) AASLD advises use of the BCLC system(3) Routine postoperative surveillance should be performed to detectrecurrence using contrast-enhanced multiphasic CT or MRI every 3–6months for all patients with HCC following liver resection(4) AASLD recommends against routine use of HCC surveillance in patientswith HCV infection post-SVR with advanced fibrosis but without cirrhosis(A) (3)＋(4)(B) (1)＋(2)(C) (3)(D) (1)＋(2)＋(3)(E) (1)＋(2)＋(3)＋(4)

71. 依據 IMbrave050 Phase III clinical trial，下列何者為 High Risk features？(1) Surgical resection: 3 tumors, the largest one 4.5cm, no vascular invasion,Grade 2 tumor differentiation(2) Radiofrequency ablation (RFA): Single tumor, 2.5cm(3) Surgical resection: single tumor, 4cm, no vascular invasion, Grade 3 tumordifferentiation(4) Surgical resection: single tumor, 6cm, no vascular invasion, Grade 2 tumordifferentiation(A) (3)＋(4)(B) (1)＋(3)(C) (1)＋(4)(D) (1)＋(2)＋(3)＋(4)(E) (2)＋(3)＋(4)

72. 關於 HCC systemic therapy，依據 phase 3 clinical trials 的結果，下列敘述何者正確？(1) Atezolizumab + Bevacizumab 在一線 systemic therapy，objective responserate (ORR) ＞30%(2) Himalaya trial 受試者，viral HCC 比例＞70%(3) Tremelimumab (300 mg, one dose) plus durvalumab (1500 mg every 4weeks; STRIDE)的 ORR 為 25%(4) Median progression-free survival (PFS)，lenvatinib 不亞於 Atezolizumab +Bevacizumab(A) (1)(B) (1)＋(2)＋(4)(C) (1)＋(3)＋(4)(D) (1)＋(2)＋(3)＋(4)(E) (1)＋(4)

73. 依據 2023 AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma，下列何者敘述正確？(1) Patients with advanced HCC who have Child-Turcotte-Pugh A cirrhosisshould be offered atezolizumab plus bevacizumab or durvalumab plustremelimumab as preferred first-line therapy options(2) Patients with recent GI bleeding within 6 months and those with high-riskstigmata for bleeding on EGD should have varices adequately treated priorto atezolizumab plus bevacizumab initiation, or these patients may beconsidered for durvalumab plus tremelimumab(3) AASLD advises sorafenib or lenvatinib as preferred agents after first-linedurvalumab plus tremelimumab if patients are not eligible for clinical trials(4) Well-selected patients with Child-Turcotte-Pugh B cirrhosis may be offeredsorafenib, lenvatinib, or single-agent anti-PD1 or anti-PDL1 ICI therapy(A) (3)＋(4)(B) (1)＋(2)＋(4)(C) (3)(D) (1)＋(2)＋(3)(E) (1)＋(2)＋(3)＋(4)

74. 關於 Liver Imaging Reporting and Data System (LI-RADS) system，下列敘述何者錯誤？(1) AASLD advises multidisciplinary discussion to determine optimal follow-upfor patients with LI-RADS -3 observations(2) Biopsy should be performed for patients with LR-M observations(3) LI-RADS -5 lesions have a 95%–99% probability of being HCC(4) LI-RADS -3 observations have a ∼30% probability of HCC(5) AASLD advises continued surveillance with repeat CT or MRI in 3–6 monthsfor LI-RAD-2 lesions(A) (1)(B) (2)(C) (1)＋(2)(D) (1)＋(4)＋(5)(E) (1)＋(5)