乙型肝炎血清转换是否影响乙型肝炎相关肝细胞癌患者的生

StephenW

Transl Gastroenterol Hepatol. 2016 Jun 14;1:51. doi: 10.21037/tgh.2016.05.11. eCollection 2016.
Does hepatitis B seroconversion affect survival outcome in patients with hepatitis B related hepatocellular carcinoma?Yip VS1, Cheung TT1, Poon RT1, Yau T2, Fung J2, Dai WC1, Chan AC1, Chok SH1, Chan SC1, Lo CM1.
Author information

• 1Department of Hepato-Pancreato-Biliary Surgery, Queen Mary Hospital, Hong Kong, China.
• 2Department of Medical Medicine, Queen Mary Hospital, Hong Kong, China.
  

AbstractBACKGROUND: Little is known about whether hepatitis B surface antigen (HBsAg) seroconversion (SC) contributes to any survival benefits for patients with hepatocellular carcinoma (HCC).
METHODS: All patients with hepatitis B-related HCC and HBsAg seroclearance between 1989 and 2013 were identified. Case- and control-groups were matched according to their stage of disease and mode of treatment. Baseline demographics, liver function, and overall survivals (OS) were compared between these two groups.
RESULTS: Thirty-nine HCC cases with HBsAg SC were identified, and 312 non-seroconversion (NSC) HCC cases were matched. Forty-eight percent of patients had curative resections, 14% were treated with ablation and 38% were for palliation. Age of patients in SC group was older than those in NSC group (P=0.026). Although there was significantly better liver function in SC vs. NSC groups in terms of bilirubin (P=0.027), albumin (P=0.003), AST (P=0.001) and ALT (P<0.001), there was no overall difference in Child-Pugh grade among the two groups. In regarding tumour pathology, SC commonly presented with solitary tumour nodule as compared to multiple nodules in NSC (P=0.027), and was also frequently associated with a normal background liver parenchyma (P<0.001). Although no survival benefit was confirmed in log-rank analysis between SC and NSC, the absolute 5-year survival of SC group was better in resection (72.2% vs. 55.3%), ablation (83.3% vs. 57.4%) and palliation (24.4% vs. 14.4%).
CONCLUSIONS: HCC patients with HBsAg SC are associated with a better background liver parenchyma and function, and might contribute to an improved long-term survival.


KEYWORDS: Hepatocellular carcinoma (HCC); hepatitis B; seroconversion (SC)

PMID:28138618DOI:10.21037/tgh.2016.05.11

StephenW

翻译胃肠素Hepatol。 2016 Jun 14; 1：51。 doi：10.21037 / tgh.2016.05.11。 eCollection 2016。
乙型肝炎血清转换是否影响乙型肝炎相关肝细胞癌患者的生存结果？
Yip VS1，Cheung TT1，Poon RT1，Yau T2，Fung J2，Dai WC1，Chan AC1，Chok SH1，Chan SC1，Lo CM1。
作者信息

    1.中国香港玛丽医院肝胆胰胆道外科。
    中国香港玛丽医院医学医学科。

抽象
背景：

很少知道乙型肝炎表面抗原（HBsAg）血清转化（SC）是否有助于肝细胞癌（HCC）患者的任何生存获益。
方法：

确定了1989年至2013年所有乙型肝炎相关的HCC和HBsAg血清清除的患者。病例组和对照组根据其疾病阶段和治疗方式进行匹配。在这两组之间比较基线人口统计学，肝功能和总体存活（OS）。
结果：

鉴定了59个HBsAg SC的HCC病例，并且312个非血清转化（NSC）HCC病例匹配。 48％的患者有治愈性切除术，14％的患者接受消融治疗，38％的患者接受姑息治疗。 SC组患者年龄大于NSC组（P = 0.026）。尽管SC与NSC组的肝功能在胆红素（P = 0.027），白蛋白（P = 0.003），AST（P = 0.001）和ALT（P <0.001）方面有显着更好的肝功能， Child-Pugh等级在两组之间。在肿瘤病理学方面，SC与NSC中的多发性结节（P = 0.027）相比，通常表现为孤立性肿瘤结节，并且经常与正常的背景肝实质相关（P <0.001）。虽然在SC和NSC之间的对数秩分析中没有证实存活益处，但是SC组的绝对5年生存率在切除（72.2％对55.3％），消融（83.3％对57.4％）和姑息24.4％对14.4％）。
结论：

具有HBsAg SC的HCC患者与更好的背景肝实质和功能相关，并且可能有助于改善长期存活。
关键词：

肝细胞癌（HCC）;乙型肝炎;血清转化（SC）

PMID：
    28138618
DOI：
    10.21037 / tgh.2016.05.11