Hepatitis B Virus Seropositivity Is a Poor Prognostic Factor of Pediatric Hepatocellular Carcinoma: a Population-Based Study in Hong Kong and Singapore.
Hepatitis B Virus Seropositivity Is a Poor Prognostic Factor of Pediatric Hepatocellular Carcinoma: a Population-Based Study in Hong Kong and Singapore.
复制标题
DOI：
10.3389/fonc.2020.570479
复制
发表时间：
2020
影响因子：
4.7
通讯作者：
Chiang AKS
中科院分区：
文献类型：
--
作者：
Liu APY;Soh SY;Cheng FWC;Pang HH;Luk CW;Li CH;Ho KKH;Chan EKW;Chan ACY;Chung PHY;Kimpo MS;Ahamed SH;Loh A;Chiang AKS
肝细胞癌是一种罕见的儿童肝脏恶性肿瘤。B型肝炎病毒（HBV）感染是流行地区的一个关键易感因素，但其对预后的影响尚未研究。我们的目的是评估HBV血清阳性的预后意义和癌症监测在东亚国家HBV疫苗接种人群中HCC儿童中的作用。回顾了两个东南亚地区1993年至2017年期间诊断为HCC的患者（<18岁）的基于人群的数据库，这些地区接受了普遍的HBV疫苗接种（分别自1988年和1987年在香港和新加坡开始）。确定了39例患者（香港，28例;新加坡，11例）。30例为男性;诊断时的中位年龄为10.8岁（范围，0.98 - 16.6）。腹痛是最常见的表现，而五名患者是通过监测基础疾病诊断的。36例患者甲胎蛋白升高（平均500，598 ng/ml）。19例患者有双叶受累，其中治疗前疾病程度（PRETEXT）分期可以回顾性分配，3例为I期，13例为II期，4例为III期，11例为IV期疾病。17例远处转移。38例患者中19例HBsAg阳性。2例患者患有纤维板层型HCC。前期治疗包括16例肿瘤切除（肝移植，2例），21例全身化疗，6例介入治疗[经动脉化疗栓塞（TACE），5例，射频消融（RFA），1例]，4例放疗（选择性内放疗，3例，外照射，1例）。5年无事件生存率（EFS）和总生存率（OS）分别为15.4 ± 6.0%和26.1 ± 7.2%。在单变量和多变量分析中，患者的HBsAg阳性、转移性疾病和不能进行确定性切除是预后不良的因素。通过监测诊断的患者预后明显更好。儿童HCC预后差。HBV状态在普遍HBV疫苗接种时代仍然相关。HBV携带者预后较差，使用监测可减轻病程。
Hepatocellular carcinoma (HCC) is a rare hepatic malignancy in children. Hepatitis B virus (HBV) infection is a key predisposing factor in endemic regions but its impact on outcome has not been studied. We aim to evaluate the prognostic implication of HBV seropositivity and role of cancer surveillance in children with HCC from East Asian populations with national HBV vaccination. Review of population-based databases for patients (< 18 years old) diagnosed with HCC from 1993 to 2017 in two Southeast Asian regions with universal HBV vaccination (instituted since 1988 and 1987 in Hong Kong and Singapore, respectively). Thirty-nine patients were identified (Hong Kong, 28; Singapore, 11). Thirty were male; median age at diagnosis was 10.8 years (range, 0.98–16.6). Abdominal pain was the commonest presentation while five patients were diagnosed through surveillance for underlying condition. Alpha-fetoprotein was raised in 36 patients (mean, 500,598 ng/ml). Nineteen had bilobar involvement, among the patients in whom pretreatment extent of disease (PRETEXT) staging could retrospectively be assigned, 3 had stage I, 13 had stage II, 4 had stage III, and 11 had stage IV disease. Seventeen had distant metastasis. HBsAg was positive in 19 of 38 patients. Two patients had fibrolamellar HCC. Upfront management involved tumor resection in 16 (liver transplantation, 2), systemic chemotherapy in 21, interventional procedures in 6 [transarterial chemoembolization (TACE), 5, radiofrequency ablation (RFA), 1], and radiotherapy in 4 (selective internal radiation, 3, external beam radiation, 1). Five-year event-free survival (EFS) and overall survival (OS) were 15.4 ± 6.0 and 26.1 ± 7.2%, respectively. Patient’s HBsAg positivity, metastatic disease and inability to undergo definitive resection represent poor prognostic factors in univariate and multivariable analyses. Patients diagnosed by surveillance had significantly better outcome. Pediatric HCC has poor outcome. HBV status remains relevant in the era of universal HBV vaccination. HBV carrier has inferior outcome and use of surveillance may mitigate disease course.
登录
查看更多内容
影响因子：
4
作者：
Tajiri, Hitoshi;Takano, Tomoko;Tanaka, Hideo;Ushijima, Kosuke;Inui, Ayano;Miyoshi, Yoko;Ozono, Keiichi;Abukawa, Daiki;Endo, Takeshi;Brooks, Stephen;Tanaka, Yasuhito
通讯作者：
Tanaka, Yasuhito
影响因子：
8.4
作者：
Ng, Yixiang;Chua, Lily Ai Vee;Lee, Vernon Jian Ming
通讯作者：
Lee, Vernon Jian Ming
影响因子：
45.3
作者：
Zsiros, Jozsef;Maibach, Rudolf;Perilongo, Giorgio
通讯作者：
Perilongo, Giorgio
DOI：
10.1097/mpg.0000000000002285
发表时间：
2019-05-01
影响因子：
2.9
作者：
Cowell, Elizabeth;Patel, Kalyani;Miloh, Tamir
通讯作者：
Miloh, Tamir
影响因子：
6.4
作者：
Tai, Chi-San;Wu, Jia-Feng;Chang, Mei-Hwei
通讯作者：
Chang, Mei-Hwei