Association of hepatitis status with surgical outcomes in patients with dual hepatitis B and C related hepatocellular carcinoma.
Association of hepatitis status with surgical outcomes in patients with dual hepatitis B and C related hepatocellular carcinoma.
复制标题
乙型肝炎和丙型肝炎相关肝细胞癌患者的肝炎状态与手术结果的关联。
DOI：
10.1186/s13027-017-0137-6
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发表时间：
2017
影响因子：
3.7
通讯作者：
Ding ZB
中科院分区：
文献类型：
--
作者：
Fu XT;Shi YH;Zhou J;Peng YF;Liu WR;Shi GM;Gao Q;Wang XY;Song K;Fan J;Ding ZB
背景血清学肝炎标志物决定伴发B型肝炎（HBV）或丙型肝炎（HCV）的肝细胞癌（HCC）的手术预后的概念已被明确。然而，鲜为人知的是，手术结果和血清学肝炎标志物之间的关系，在患者的双重HBV和HCV相关hcch.MethodsA回顾性分析的临床资料，39例肝癌患者的HBV-HCV合并感染谁接受根治性肝切除术之间的2001年和2011年进行。结果考克斯比例风险模型确定HBV DNA定量≥ 1,000 IU/mL、HBeAg血清阳性、肿瘤大小> 5 cm、多发肿瘤、肿瘤大小> 5 cm、肿瘤大小>血管侵犯是影响肝癌预后的危险因素。因此，进一步分析了HBV DNA定量、HBsAg水平、HBeAg状态和可能揭示肝炎状态的HCV抗体水平。HBV DNA定量高（≥ 1，000 IU/mL）组的总生存时间显著低于HBV DNA定量低（<1，000 IU/mL）组。同样，与低HBsAg水平相比，高HBsAg水平（≥ 1，000 IU/mL）与生存率差相关。此外，HBeAg血清阳性决定了更高的累积死亡风险。HCV抗体低水平组（<10.9S/CO）与高水平组（≥ 10.9S/CO）的总生存期差异无统计学意义。HCV-Ab低水平组血清HBsAg水平明显高于HCV-Ab高水平组。此外，我们分析的数据显示，这4种肝炎血清学标志物与累积复发率无关。多因素分析显示，血清学肝炎标志物均不是影响B型和C型双重肝炎患者预后的独立因素。结论在合并HBV和HCV感染的HCC患者中，术前HBV DNA定量高或HBeAg血清学阳性者生存时间短，预后较差。血清学上HBV状态的表达而不是HCV状态可能潜在地主导中国HBV-HCV合并感染的HCC患者的手术结果。
BackgroundThe conception that serological hepatitis markers determined surgical prognosis of hepatocellular carcinoma (HCC) associated with hepatitis B (HBV) or hepatitis C (HCV) has been well defined. However, little is known about the relationship between surgical outcomes and serological hepatitis markers in patients with dual HBV and HCV related HCC.MethodsA retrospective analysis of the clinical data of 39 HCC patients with HBV-HCV coinfection who underwent curative hepatectomy between 2001 and 2011 was performed. HBV DNA quantification, expression of HBV antigens, anti-HCV signal-to-cutoff ratio (S/CO) and some clinicopathological characteristics were investigated to show the potential relationship among them and the surgical prognosis.ResultsThe Cox proportional hazards model identified that HBV DNA quantification of 1,000 IU/mL or higher, HBeAg seropositivity, tumor size of greater than 5 cm, multiple tumors, and vascular invasion were risk factors for HCC prognosis. Thus, HBV DNA quantification, HBsAg level, HBeAg status and HCV-Ab level which may reveal the hepatitis status were further analyzed. The overall survival time in the group with high (≥1,000 IU/mL) HBV DNA quantification was significantly lower than the group with low (<1,000 IU/mL) HBV DNA quantification. Similarly, the high HBsAg level (≥1,000 IU/mL) was associated with poor survival compared with the low HBsAg level. Moreover, HBeAg seropositivity determined a higher cumulative risk for death. However, no significant difference was observed in overall survival time between the groups with low (<10.9 S/CO) and high (≥10.9 S/CO) HCV-Ab level. Compared to HCV-Ab high-level group, the serological HBsAg level was observed significantly higher in HCV-Ab low-level group. Furthermore, the data we analyzed showed these 4 serological hepatitis markers were not correlated with cumulative recurrence rate. On multivariate analysis, none of serological hepatitis markers was an independent prognostic factor for HCC patients with dual hepatitis B and C.ConclusionAmong HCC patients with HBV-HCV coinfection, those who with preoperatively high HBV DNA quantification or HBeAg seropositivity had a short survival time and served as poor survival indicators. Serological expression of HBV status rather than HCV status might potentially dominate the surgical outcomes of the Chinese HCC patients with HBV-HCV coinfection.