High HBV-DNA Titer in Surrounding Liver Rather Than in Hepatocellular Carcinoma Tissue Predisposes to Recurrence After Curative Surgical Resection
High HBV-DNA Titer in Surrounding Liver Rather Than in Hepatocellular Carcinoma Tissue Predisposes to Recurrence After Curative Surgical Resection
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DOI：
10.1097/mcg.0b013e3182371285
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发表时间：
2012-05-01
影响因子：
2.9
通讯作者：
Lee, Young Joo
中科院分区：
文献类型：
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作者：
Choi, Jong Gi;Chung, Young-Hwa;Lee, Young Joo
目标：在这项研究中，作者旨在研究肝内B型肝炎病毒（HBV）-DNA浓度与HBV相关肝细胞癌（HCC）切除术后复发之间的关系。背景：高HBV-DNA水平与慢性HBV感染的HCC发展密切相关，并被认为是HCC复发的危险因素。共109例接受根治性手术切除的HBV相关HCC患者每3至6个月随访一次，中位时间为82个月。采用TaqMan探针实时定量聚合酶链反应方法检测HCC及周围肝组织中肝内总HBV-DNA滴度。根据患者的临床、影像学和组织病理学特征，比较HCC和周围肝组织中HBV-DNA滴度。结果：109例肝癌患者中，67例（62%）术后复发，复发率为100%。在所有患者中，总HBV-DNA滴度在HCC中显著高于周围肝组织（P = 0.019）。周围肝组织中HBV-DNA滴度高者复发率高于低者（P = 0.009）。与此相反，HCC标本中HBV-DNA滴度较高和较低的患者的HCC复发率相似（P = 0.301）。多因素分析显示肿瘤大小> 5cm（P = 0.008），存在门静脉血栓（P = 0.001），周围肝组织HBV-DNA滴度高（P = 0.002）是HBV相关HCC患者术后HCC复发的独立危险因素。在HBV相关的HCC患者中，周围肝脏中的高HBV-DNA滴度而不是HCC本身与根治性手术切除后HCC复发相关。
Goals: In this study the authors intended to investigate the relationship between intrahepatic hepatitis B virus (HBV)-DNA concentrations and posthepatectomy recurrence of HBV-associated hepatocellular carcinoma (HCC).Background: High HBV-DNA level is strongly associated with HCC development in chronic HBV infection and considered to be a risk factor of HCC recurrence.Study: A total of 109 patients with HBV-associated HCC who underwent curative surgical resection were followed up every 3 to 6 months for a median of 82 months. Intrahepatic total HBV-DNA titer was measured in HCC and surrounding liver tissues using a TaqMan probe-based real-time polymerase chain reaction method. HBV-DNA titers in HCC and surrounding liver were compared in accordance with patients' clinical, radiologic, and histopathological characteristics. The relationships between HBV-DNA titers in HCC or surrounding liver tissues and cumulative HCC recurrence rates were determined.Results: Of the 109 patients, 67 (62%) showed posthepatectomy recurrence of HCC. In all patients, total HBV-DNA titers were significantly higher in HCCs than in surrounding liver tissues (P = 0.019). HCC recurred more frequently in patients with higher than those with lower HBV-DNA titers in surrounding liver tissues (P = 0.009). In contrast, the HCC recurrence rates were similar in patients with higher and those with lower HBV-DNA titers in HCC specimens (P = 0.301). Multivariate analysis showed that tumor size > 5 cm (P = 0.008), the presence of portal vein thrombus (P = 0.001), and high HBV-DNA titer in surrounding liver tissues (P = 0.002) were independent risk factors for posthepatectomy HCC recurrence in patients with HBV-associated HCC.Conclusions: In patients with HBV-associated HCC, high HBV-DNA titer in surrounding liver rather than in the HCC itself is associated with posthepatectomy HCC recurrence after curative surgical resection.