标题: High Hepatitis B Viral Load Predicts Recurrence of Small HCC [打印本页] 作者: liver411 时间: 2010-5-6 06:47 标题: High Hepatitis B Viral Load Predicts Recurrence of Small HCC
after Curative Resection
J Gastrointest Surg. 2010 Apr 27. [Epub ahead of print]
High Hepatitis B Viral Load Predicts Recurrence of Small Hepatocellular
Carcinoma after Curative Resection.
Qu LS, Jin F, Huang XW, Shen XZ.
Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan
University, 180# Fenglin Road, Shanghai, 200032, China.
Abstract
A retrospective cohort study was conducted to identify risk factors for
recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC)
after curative resection. A total of 317 patients who had received curative
resection of pathologically proven small HCC (</=3 cm in diameter) were
analyzed to ascertain the factors affecting recurrence. The median follow-up
period was 33.7 months. Cumulative recurrence rates at 1, 3, and 5 years after
resection were 23.5%, 49.5%, and 65.5%, respectively. Male sex,
alpha-fetoprotein (AFP)>/=400 ng/mL, HBV DNA level>/=4 log(10) copies/mL,
prolonged prothrombin time, tumor size>/=2 cm, microvascular invasion, absence
of capsular formation, moderate/poor tumor differentiation, and absence of
postoperative interferon-alpha (IFN-alpha) treatment were associated with
increased cumulative risk of HCC recurrence. By multivariate analysis, HBV DNA
level>/=4 log(10) copies/mL (P < 0.001, hazard ratio (HR) 2.110), AFP>/=400
ng/mL (P = 0.011, HR 1.574), microvascular invasion (P < 0.001, HR 1.767), and
postoperative IFN-alpha treatment (P = 0.022, HR 0.562) remained to be
independently associated with HCC recurrence. Those contributing to late
recurrence (>2 years) were older age and HBV DNA level>/=4 log(10) copies/mL.
Patients with persistent HBV DNA level>/=4 log(10) copies/mL at resection and
follow-up had the highest recurrence risk (P < 0.001, HR 4.129). HBV DNA
level>/=4 log(10) copies/mL at the time of resection was the most important
risk factor for recurrence. Postoperative IFN-alpha treatment significantly
decreased the recurrence risk after resection.
PMID: 20422305 [PubMed - as supplied by publisher作者: afang1989 时间: 2010-5-9 20:09