Hepatitis B or C virus serology as a prognostic factor in patients with hepatocellular carcinoma
Hepatitis B or C virus serology as a prognostic factor in patients with hepatocellular carcinoma
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DOI：
10.1016/s1091-255x(01)80084-6
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发表时间：
2001-09-01
影响因子：
3.2
通讯作者：
Curley, SA
中科院分区：
文献类型：
--
作者：
Ahmad, SA;Bilimoria, MM;Curley, SA
慢性B或C型肝炎病毒（HBV或HCV）感染是否是肝细胞癌的预后因素尚不清楚。我们进行了这项研究，以确定慢性HBV或HCV感染是否对切除术后生存率或受影响的失败模式有任何影响。回顾性分析1990年1月至1998年12月间77例原发性肝癌手术切除的病例。44例患者（57%）有HCV感染，18例患者（23%）有HBV感染，15例患者（20%）血清学阴性。各组之间在年龄、性别或肿瘤大小方面没有差异，所有患者均行边缘阴性切除术。HCV感染组中，无精子症和血管侵犯的发生率明显高于其他组（分别为32%和41%，P < 0.05）。中位随访时间为30个月，HBV阳性（5年LDFS 26%）或HCV阳性（5年LDFS 38%）患者的局部无病生存率（LDFS）显著低于血清学阴性患者（5年LDFS 79%; P < 0.05）。与血清学阴性患者相比，肝炎血清学阳性患者的总生存率也有下降的趋势（37% vs. 79%; P = 0.12）。单因素分析显示，只有卫星化与局部复发和总生存率有关。与血清学阴性的患者相比，接受肝细胞癌切除术的B或C型肝炎血清学阳性的患者有总体预后更差的趋势，LDFS显著降低。
It is not clear whether chronic hepatitis B or C virus (HBV or HCV) infection is a prognostic factor for hepatocellular carcinoma. We performed this study to determine if chronic HBV or HCV infection had any impact on postresection survival or affected patterns of failure. The records of 77 patients undergoing surgical resection for hepatocellular carcinoma between January 1990 and December 1998 were reviewed. Forty-four patients (57%) had HCV infection, 18 patients (23%) had HBV infection, and 15 patients (20%) had negative serology. There were no differences in age, sex, or tumor size among the groups, and all patients had margin-negative resections. There was a significantly higher incidence of atellitosis and vascular invasion in patients with HCV infection (32% and 41%, respectively; P < 0.05 vs. other groups). With a median follow-up of 30 months, a significantly decreased local disease-free survival (LDFS) was seen in HBV-positive (5-year LDFS 26%) or HCV-positive (5-year LDFS 38%) patients compared to those with negative serology (5-year LDFS 79%; P < 0.05). There was also a trend toward a decreased overall survival in patients with positive hepatitis serology compared to patients with negative serology (37% vs. 79%; P = 0.12). Univariate analysis revealed that only satellitosis was related to local recurrence and overall survival. Patients with positive serology for hepatitis B or C undergoing resection for hepatocellular carcinoma have a trend toward worse overall prognosis and a significantly decreased LDFS when compared to patients with negative serology.