Hepatitis B Virus Infection is a Prognostic Biomarker for Better Survival in Operable Esophageal Cancer: Analysis of 2,004 Patients from an Endemic Area in China
Hepatitis B Virus Infection is a Prognostic Biomarker for Better Survival in Operable Esophageal Cancer: Analysis of 2,004 Patients from an Endemic Area in China
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乙型肝炎病毒感染是可手术食管癌患者更好生存的预后生物标志物：对中国流行区 2004 名患者的分析。
DOI：
10.1158/1055-9965.epi-18-1095
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发表时间：
2019-06-01
影响因子：
3.8
通讯作者：
Zhang, Shuishen
中科院分区：
文献类型：
--
作者：
Zou, Jianyong;Chen, Junying;Zhang, Shuishen
背景：B型肝炎病毒（HBV）感染已被证明与许多癌症的生存有关。然而，HBV感染在食管癌的患病率和预后价值尚未调查yould.Methods：共2000年至2008年期间接受食管切除术的2,004例食管癌患者在我们的研究中招募。ELISA法检测血清HBV标志物。将患者分为HBsAg阳性组（HBV感染）和HBsAg阴性组。采用Kaplan-Meier法和考克斯比例风险模型评估HBV感染对无病生存期（DFS）和总生存期（OS）的影响。HBeAg阳性患者的早期病理T分期率明显高于HBeAg阴性患者，肝转移率和肝外转移率明显低于HBeAg阴性患者。与HBsAg阴性患者相比，HBsAg阳性患者的DFS [HR = 0.79; 95%CI：0.66-0.94，P = 0.007]和OS [HR = 0.80; 95%CI：0.65-0.95，P = 0.020]分别较好。亚组分析显示，HBV感染与食管鳞状细胞癌和晚期病理分期（III-IV）患者的DFS和OS较好相关。结论：HBV感染是可手术食管癌患者生存的独立有利预后因素。我们的大型队列研究提供了更明确和定量的证据，表明HBV感染是一种独立的有利的预后生物标志物，食管癌，特别是食管鳞状细胞癌和晚期病理分期（III-IV）患者。
Background: Hepatitis B Virus (HBV) infection has been proven to be associated with the survival of many cancers. However, the prevalence and prognostic value of HBV infection in esophageal cancer has not been investigated yet.Methods: A total of 2,004 consecutive esophageal cancer patients who underwent esophagectomy between 2000 and 2008 were recruited in our study. ELISA was used to test serum HBV markers. Patients were divided into HBsAg-positive group (HBV infection) and HBsAg-negative group. The impact of HBV infection on disease-free survival (DFS) and overall survival (OS) was estimated using the Kaplan-Meier method and Cox proportional hazard models.Results: HBV infection was found in 12.6% (253/2,004) of patients. HBsAg-positive patients had significantly higher percentage of early pathologic T stage, lower frequency of liver metastasis, and extrahepatic metastasis than HBsAg-negative. HBsAg-positive patients had a favorable DFS [HR = 0.79; 95% confidence interval (CI): 0.66-0.94, P = 0.007) and OS (HR = 0.80; 95% CI: 0.65-0.95, P = 0.020] respectively, when compared with HBsAg-negative patients. Subgroup analysis showed that the association with HBV infection and better DFS and OS was observed in patients with esophageal squamous cell carcinoma and advanced pathologic stage (III-IV).Conclusion: HBV infection was an independent favorable prognostic factor for survival in operable esophageal cancer.Impact: Our large cohort study provided more definite and quantitative evidence that HBV infection is an independent favorable prognostic biomarker in patients with esophageal cancer, especially in patients with esophageal squamous cell carcinoma and advanced pathologic stage (III-IV).