The impact of hepatitis B viral load on recurrence after complete necrosis in patients with hepatocellular carcinoma who receive transarterial chemolipiodolization - Implications for viral suppression to reduce the risk oil cancer recurrence
The impact of hepatitis B viral load on recurrence after complete necrosis in patients with hepatocellular carcinoma who receive transarterial chemolipiodolization - Implications for viral suppression to reduce the risk oil cancer recurrence
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DOI：
10.1002/cncr.22984
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发表时间：
2007-10-15
期刊：
影响因子：
6.2
通讯作者：
Lee, Chang Don
中科院分区：
文献类型：
--
作者：
Jang, Jeong Won;Choi, Jong Young;Lee, Chang Don
背景肝细胞癌（HCC）在根治性治疗后有很高的复发倾向。除了肿瘤和肝功能参数外，对B型肝炎病毒（HBV）因子在HCC复发中的作用知之甚少。本研究的目的是确定接受经动脉化疗碘油化的患者中病毒载量和HCC复发之间的潜在关系。这是一项对62例连续HBV相关HCC患者进行的队列研究，这些患者通过经动脉化疗碘油化实现了完全坏死。对包括治疗后复发的病毒载量在内的风险因素进行了分析。总体而言，62例患者中有32例（51.6%）在研究期间（7.2-37.5个月）复发。多变量分析确定Child-Pugh分级B（P = .014）、多发性肿瘤（P = .013）和完全坏死时高病毒载量（HBV DNA水平>10（5）拷贝/mL）（P = .001）为复发的独立危险因素。在单变量和多变量分析中，完全坏死时的高病毒载量被确定为复发的最强因素;此外，即使分别对局部复发（P = .018）和远处复发（P = .009）进行分析，仍观察到其统计学显著性影响。在接受经动脉化疗碘油化的个体中，完全坏死时的高HBV病毒载量是治疗后复发的最重要的危险因素之一，无论复发的位置模式如何。目前的研究结果强调了未来工作的必要性，即测试抗病毒治疗的适用性，以降低这种情况下HCC复发的风险。
BACKGROUND. Hepatocellular carcinoma (HCC) has a high tendency for recurrence after radical treatment. Apart from tumor and liver function parameters, little is known about the role of hepatitis B virus (HBV) factors in the recurrence of HCC. The objective of this study was to identify the potential relation between viral load and HCC recurrence in patients undergoing transarterial chemolipiodolization.METHODS. This was a cohort study of 62 consecutive patients who had HBV-related HCC and achieved complete necrosis with transarterial chemolipiodolization. Risk factors, including viral load for posttreatment recurrence, were analyzed.RESULTS. Overall, 32 of 62 patients, (51.6%) developed a recurrence during the study period (7.2-37.5 months). Multivariate analysis established Child-Pugh Class B (P = .014), multiple tumors (P = .013), and high viral load (HBV DNA levels >10(5) copies/mL) at complete necrosis (P = .001) as independent risk factors for recurrence. On both univariate and multivariate analyses, high viral load at the time of complete necrosis was identified as the strongest factor for recurrence; moreover, its statistically significant effects still were observed even when conducting the analyses separately for both local recurrence (P = .018) and distant recurrence (P = .009).CONCLUSIONS. Among individuals who underwent transarterial chemolipiodolization, high HBV viral load at complete necrosis was among the most important risk factors for posttreatment recurrence, irrespective of the locational pattern of recurrence. The current findings underscored the need for future work that tests the applicability of antiviral therapy to reduce the risk of HCC recurrence in this setting.