山东大学齐鲁医院肝胆外科李涛副主任医师和复旦大学附属中山医院肝癌研究所樊嘉教授及其团队合作，近日完成的一项临床回顾性研究表明，抗-HBc阳性与HBV相关HCC早期复发及根治性切除术后低生存率相关,该文章发表在国际肝脏病学会官方杂志Liver Internatinal(SCI,IF:4.9)。

研究共纳入3388例经根治性肝切除的HBsAg阳性肝细胞肝癌（HCC）患者。运用Cox比例风险回归模型进行独立预后因素多变量分析，结果显示抗-HBc阳性是HBV相关HCC患者无复发生存率（RFS）的独立预测因子（HR=1.723，95%CI：1.278~2.324，P<0.001）。抗-HBc阴性患者的1、3、5年的RFS均显著高于抗-HBc阳性患者 （92.5% vs. 77.9%， 72.1% vs. 58.6%，and 65.9% vs. 46.9%；P<0.001）。< span="">

临床上，抗-HBc阳性患者的肿瘤更大、且多无包膜，血管侵犯更常见，AFP及ALT水平也更高。此项研究显示，血管侵犯、肿瘤大小、干扰素-α治疗、AFP、GGT水平、HBcAb阳性均是HBV相关HCC患者早期肝内复发的独立预测因素。

研究者认为，抗-HBc阳性的HCC患者的临床表型多具有侵袭性，多预示着术后具有早期肝内复发的高风险性和较差的远期生存。

原文链接：Li T(1), Wang SK(2), Zhou J(3), et al. Positive HBcAb is associated with higher risk of early recurrence and poorer survival after curative resection of HBV-related HCC. Liver Int. 2015 Jun 22.

文章来源：国际肝病网

Liver Int.2015 Jun 22. doi: 10.1111/liv.12898. [Epub ahead of print]

PositiveHBcAbisassociatedwithhigherriskofearlyrecurrenceandpoorersurvivalaftercurativeresectionofHBV-relatedHCC.

Li T1,Wang SK2,Zhou J3,Sun HC3,Qiu SJ3,Ye QH3,Wang L3,Fan J3.

Author information

BACKGROUND & AIMS:

Previous studies predicted the prognosis of hepatocellular carcinoma (HCC) mainly based on tumour-related factors, whereas the impacts of hepatitis B virus (HBV)-related factors are usually ignored. The objective of this exploratory study was to investigate the prognostic role of hepatitis B core antibody (HBcAb) on post-operativesurvivalandrecurrenceofHCC.

METHODS:

A retrospective analysis of 3388 HBsAgpositive(HBV-related)HCCpatients treated bycurativeresectionwas performed. Multivariate analysis of independent prognostic factors was performed by Cox proportional hazards regression model.

RESULTS:

HBcAbpositivity was an independent prognostic factor forrecurrence-freesurvival(RFS) ofHBV-relatedpatients (P<0.001, HR: 1.723, 95% CI: 1.278-2.324), and the 1-, 3-, 5-year RFS rates forHBcAb-negative patients were significantly better than those ofHBcAb-positivepatients (92.5%, 72.1% and 65.9% vs 77.9%, 58.6% and 46.9%, P<0.001).HBcAb-positiveHCCwas much bigger (P=0.006), more often involved with vascular invasion (P=0.001), elevated AFP (P=0.001) and ALT (P=0.046) levels, but less often involved with capsule formation (P=0.034). Besides vascular invasion, tumour size, interferon-α treatment, AFP and GGT level,HBcAbpositivity was an independent prognostic factor forearlyintrahepaticrecurrenceofHBV-relatedpatients (P=0.025, HR: 1.766, 95% CI: 1.073-2.907) and the majority ofHBcAb-positiverecurrencewereearlyrecurrencewhile most ofHBcAb-negativerecurrencewere laterecurrence(P=0.004).

CONCLUSION:

PositiveHBcAbmay represent a more invasive phenotype ofHBV-relatedHCC, and isassociatedwith ahigherriskofearlyintrahepaticrecurrenceandpoorerRFS ofHBV-relatedpatientsaftercurativeresection.

2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

KEYWORDS:

hepatitis; hepatocellular carcinoma; prognosis; prognostic factors;recurrence

• PMID:

• 26104132

• [PubMed - as supplied by publisher]