有或没有肝硬化的乙肝相关性肝癌的肝切除术后预后特聘：

StephenW

Journal of Gastroenterology

July 2016, Volume 51, Issue 7, pp 722-732

First online: 25 November 2015
Distinguished prognosis after hepatectomy of HBV-related hepatocellular carcinoma with or without cirrhosis: a long-term follow-up analysis

    Sheng-li Yang, Li-ping Liu, Yun-fan Sun, Xing-rong Yang, Jia Fan, Jian-wei Ren, George G. Chen , Paul B. S. Lai


Abstract
Background

Conflicting results have often been observed for the prognosis of hepatocellular carcinoma (HCC) patients, but few studies have attempted to explore the reasons for the conflicting results. We aimed to distinguish the prognosis of patients with HCC with cirrhosis (HCC-C) and that of patients with HCC without cirrhosis (HCC-NC).
Methods

Patients with hepatitis B virus (HBV)-associated HCC treated by curative liver resection at a single institution between 1995 and 2013 were retrospectively evaluated. Kaplan–Meier and multivariate analyses were performed to identify risk factors, including tumor-related factors, hypoxia-inducible factor 1α expression, HBV X protein (HBx) expression, and HBx double mutations for overall survival and recurrence-free survival in these patients.
Results

The long-term prognosis of HCC-NC patients is better than that of HCC-C patients. Male sex, poor differentiation, preoperative serum alanine aminotransferase level greater than 80 IU/L, and α-fetoprotein level greater than 400 ng/mL were risk factors for overall survival among HCC-NC patients but not among HCC-C patients, and age greater than 50 years was associated with poor overall survival only in cirrhotic patients. HCC-C patients benefit more from antiviral therapy following curative hepatectomy than do HCC-NC patients. The clinical value of the biomarkers hypoxia-inducible factor 1α, HBx, and HBx double mutations for predicting HCC prognosis was significantly different between these two groups.
Conclusions

There were differences in tumor-related prognostic factors, effectiveness of the antiviral therapy after hepatectomy, and biomarkers between HCC-C and HCC-NC patients, indicating that subgroup analysis of the prognostic factors may result in better management of HCC and that HCC patients, especially those with liver cirrhosis, should be given antiviral therapy.
Keywords
Hepatocellular carcinoma Cirrhosis Hepatectomy Prognosis Biomarkers Antiviral therapy
Electronic supplementary material

StephenW

胃肠病学杂志

2016年7月，51卷，第7期，第722-732

首先在线：2015年11月25日
有或没有肝硬化的乙肝相关性肝癌的肝切除术后预后特聘：长期随访分析

    盛李阳丽萍刘云帆孙幸荣阳，樊嘉健为人，乔治G.陈保罗B. S.赖


抽象
背景

矛盾的结果往往被观察到的肝细胞癌（HCC）患者的预后，但很少有研究试图探索的结果相互矛盾的原因。我们的目的是区分HCC患者肝硬化（HCC-C）和HCC患者无肝硬化预后（HCC-NC）。
方法

乙型肝炎病毒（HBV）的患者肝癌机相关治疗由肝切除术1995至2013年间，一个单一的机构处理进行回顾性评价。 Kaplan-Meier法和多变量分析来确定的风险因素，包括肿瘤相关因子，缺氧诱导因子1α表达，这些患者总生存率和无复发生存率乙肝病毒X蛋白（HBx蛋白）的表达，HBx的双突变。
结果

HCC-NC患者的长期预后比HCC-C的患者的更好。男性，分化程度差，术前血清谷丙转氨酶水平大于80 IU / L，α胎蛋白水平大于400纳克/毫升分别为HCC-NC的患者中，但并不在HCC-C患者的总生存期，和年龄的风险因素大于50年里的总生存期只有可怜的肝硬化患者。 HCC-C患者抗病毒治疗疗效如下比切除肝癌做-NC的患者获益更多。生物标志物缺氧诱导因子1α的临床价值，为预测肝癌预后的HBx和HBx的双突变是这两个群体之间显著不同。
结论

有肿瘤相关预后因素的差异，切除后的抗病毒治疗的有效性和HCC-C和HCC-NC患者之间的生物标记物，说明预后因素的亚组分析可能导致肝癌的更好的管理和肝癌患者，特别是那些有肝硬化，应给予抗病毒治疗。
关键词
肝癌肝硬化肝切除术预后的生物标志物抗病毒治疗
电子辅助材料