Effect of smoking on survival of patients with hepatocellular carcinoma
Effect of smoking on survival of patients with hepatocellular carcinoma
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DOI：
10.1111/liv.13466
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发表时间：
2017-11-01
影响因子：
6.7
通讯作者：
Dufour, Jean-Francois
中科院分区：
文献类型：
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作者：
Kolly, Philippe;Knopfli, Marina;Dufour, Jean-Francois
背景与目的吸烟、肥胖和体育锻炼等生活方式因素在肝细胞癌领域引起了人们的兴趣。这些因素在肝细胞癌的发生发展中起着重要作用。几项研究揭示了烟草消费对肝细胞癌发展的影响及其与病毒性病因（乙型肝炎和丙型肝炎）的协同效应。在丙型肝炎感染是主要危险因素的西方队列中，尚未研究吸烟对确诊为肝细胞癌患者生存的影响。方法采用来自瑞士伯尔尼大学医院的肝细胞癌患者的前瞻性队列数据，通过Kaplan-Meier分析比较吸烟者和非吸烟者的生存率，并应用多变量Cox回归控制混杂变量。结果在238例符合条件的肝细胞癌患者中，纳入时64例为吸烟者，174例为非吸烟者。吸烟者的总生存率明显低于不吸烟者（风险比1.77,95%可信区间：1.22-2.58，P= 0.003）。根据患者的潜在肝脏疾病进行分析，发现吸烟而非不吸烟仅影响乙型肝炎病毒和丙型肝炎病毒感染患者的生存。在这个亚组中，吸烟是生存的独立预测因子（风险比2.99,95%可信区间：1.7-5.23,P . 591）
Background & AimsLifestyle factors such as smoking, obesity and physical activity have gained interest in the field of hepatocellular carcinoma. These factors play a significant role in the development of hepatocellular carcinoma. Several studies revealed the impact of tobacco consumption on the development of hepatocellular carcinoma and its synergistic effects with viral etiologies (hepatitis B and C). The effects of smoking on survival in patients with a diagnosed hepatocellular carcinoma have not yet been investigated in a Western cohort where hepatitis C infection is a major risk factor.MethodsUsing data from a prospective cohort of patients with hepatocellular carcinoma who were followed at the University Hospital of Bern, Switzerland, survival was compared by Kaplan-Meier analysis in smokers and nonsmokers, and multivariate Cox regression was applied to control for confounding variables.ResultsOf 238 eligible hepatocellular carcinoma patients, 64 were smokers at the time of inclusion and 174 were nonsmokers. Smokers had a significant worse overall survival than nonsmokers (hazard ratio 1.77, 95% confidence interval: 1.22-2.58, P=.003). Analysis of patients according to their underlying liver disease, revealed that smoking, and not nonsmoking, affected survival of hepatitis B virus and C virus-infected patients only. In this subgroup, smoking was an independent predictor for survival (hazard ratio 2.99, 95% confidence interval: 1.7-5.23, P