Quantitative HBV DNA and AST are strong predictors for survival after HCC detect

StephenW

Neth J Med. 2011 Nov-Dec;69(11):508-13.
Source: http://www.ncbi.nlm.nih.gov/pubmed/22279629
Quantitative HBV DNA and AST are strong predictors for survival after HCC
detection in chronic HBV patients. Witjes CD, IJzermans JN, van der Eijk
AA, Hansen BE, Verhoef C, de Man RA. SourceDepartment of Hepatobiliary and
Transplantation Surgery, Erasmus MC, University Medical Centre Rotterdam,
the Netherlands.

Abstract
Hepatitis B virus infection (HBV) is an important co-factor in the
development of hepatocellular carcinoma (HCC). We studied whether
quantitative HBV DNA at time of HCC detection influences survival of HCC
patients. All diagnosed HCC cases between 2000 and 2008 at our
university-based reference centre were analysed to determine the influence
of hepatitis B viral load on overall survival. Clinical and virological
findings were evaluated in univariate and multivariate analyses, survival
rates were assessed for HCC patients with a high viral load (HBV DNA ?10(5)
copies/ml) and low viral load (HBV DNA <10(5) copies/ml). HCC was
diagnosed in 597 patients, including 98 patients with HBV. The group of 37
patients (38%) who had a high viral load contained more HBeAg-positive
patients, had lower serum albumin levels and higher serum aspartate
aminotransferase (AST ) and alanine aminotransferase (ALT ) levels. The
one- and five-year survival rates of HCC patients with a high viral load
were 58% and 11% and for HCC patients with a low viral load 70% and 35%,
respectively. In multivariate analysis a higher AST level and higher viral
load were significantly associated with shorter overall survival (HR=2.30;
p=0.018, HR=1.22; p=0.015, respectively). HBeAg positivity, low albumin
level or high AST or ALT levels in HCC patients are associated with a
higher HBV DNA . HBV DNA level at detection is associated with overall
survival of HCC patients. These findings support the concept that after HCC
detection adequate suppression of HBV DNA by nucleoside analogue therapy
may improve survival.




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StephenW

Neth J MED。 2011年11月12月69（11）:508 - 13。
资料来源：http://www.ncbi.nlm.nih.gov/pubmed/22279629
定量HBV - DNA和AST肝癌后生存的强烈预测
在慢性乙型肝炎患者的检测。 Witjes CD，IJzermans JN，范德Eijk
AA，汉森，Verhoef，德曼RA。肝胆SourceDepartment和
移植手术，伊拉斯谟的MC，鹿特丹大学医学中心，
荷兰。

摘要
乙型肝炎病毒感染（HBV）是一种重要的合作因素
发展肝细胞癌（HCC）的。我们研究是否
肝癌检测时的HBV DNA的定量影响肝癌的生存
患者。 2000年和2008年之间的所有确诊肝癌病例，在我们的
大学为基础的参考中心进行分析，以确定影响
总生存期的乙肝病毒载量。临床和病毒学
在单因素和多因素分析，生存结果进行评估
肝癌患者，被评定为具有高病毒载量（HBV DNA的10（5）
拷贝/ ml）和低病毒载量（HBV DNA <10（5）拷贝/ ml）。肝癌是
确诊的597例患者，其中98例乙肝患者。本组37
高病毒载量的患者（38％）含有较多的HBeAg阳性
患者中，有降低血清白蛋白水平和较高的血清谷草
转氨酶（AST）和谷丙转氨酶（ALT）水平。 “
一个和肝癌患者的五年存活率高病毒负荷率
分别为58％和11％，低病毒载量的70％和35％的肝癌患者，
。在多变量分析了更高的AST水平和较高的病毒
显著负荷与总生存期较短（HR = 2.30;
P = 0.018，HR = 1.22，P = 0.015），分别。 HBeAg阳性，低白蛋白
水平或高AST或ALT水平在肝癌患者都伴随着
较高的乙肝病毒DNA。在检测乙肝病毒DNA水平与整体
肝癌患者的生存。这些研究结果支持这一概念后肝癌
核苷类似物治疗足够的抑制乙肝病毒DNA检测
可提高生存率。