病毒性肝炎病因对肝细胞癌生存结局的影响：大型多中心队

StephenW

J Viral Hepat. 2017 Apr 17. doi: 10.1111/jvh.12717. [Epub ahead of print]
Impact of viral hepatitis etiology on survival outcomes in hepatocellular carcinoma: a large multi-center cohort study.
Mgaieth S1, Kemp W1, Gow P2, Fink M3, Lubel J4, Nicoll A4,5, Gazzola A1, Hong T6, Ryan M6, Knight V7, Dev A7, Sood S5, Bell S6, Paul E8, Roberts SK1.
Author information

1    Department of Gastroenterology, Alfred Hospital, Melbourne, Australia.
2    Department of Gastroenterology, Austin Hospital, Melbourne, Australia.
3    Department of Surgery, Austin Hospital, Heidelberg, Australia.
4    Department of Gastroenterology, Box Hill Hospital, Box Hill, Australia.
5    Department of Gastroenterology, Royal Melbourne Hospital, Parkville, Australia.
6    Department of Gastroenterology, St Vincent's Hospital, Fitzroy, Australia.
7    Department of Gastroenterology, Monash Medical Centre, Clayton, Australia.
8    Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.

Abstract
BACKGROUND AND AIMS:

While HBV and HCV are risk factors for HCC, uncertainty exists as to whether these viral infections have prognostic significance in HCC. Thus, we compared the overall survival of patients with HBV, HCV, and non-viral HCC, and evaluated whether the presence of HBV and HCV predicts patient outcomes.
METHODS:

We conducted a multi-center study of HCC cases diagnosed at six Melbourne tertiary hospitals between Jan 2000-Dec 2014. Patient demographics, liver disease and tumor characteristics, and patient outcomes were obtained from hospital databases, computer records and the Victorian Death Registry. Survival outcomes were compared between HBV, HCV and non-viral hepatitis cases and predictors of survival determined using Cox proportional hazards regression.
RESULTS:

There were 1436 new HCC cases identified including 776 due to viral hepatitis (HBV 235, HCV 511, HBV-HCV 30) and 660 from non-viral causes. The median survival of HBV, HCV and non-viral HCC patients was 59.1, 28.4 and 20.9 months respectively (P<0.0001). On multivariate analysis, independent risk factors for survival included HCC etiology, gender, BCLC stage, serum AFP, total number and size of lesions, and serum creatinine and albumin. After adjusting for these and method of detection, HBV remained an independent predictor of improved overall survival when compared to both non-viral (HR 0.60, 95% CI 0.35-0.98; P=0.03) and HCV-related HCC (HR 0.51, 95% CI 0.30-0.85; P=0.01).
CONCLUSIONS:

In this large multicenter study, HBV is independently associated with improved overall survival compared with HCV and non-viral related HCC. Further studies are needed to determine the underlying factor(s) responsible. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.
KEYWORDS:

Hepatitis B; Hepatitis C; hepatocellular carcinoma; survival

PMID:
    28414893
DOI:
    10.1111/jvh.12717

StephenW

J病毒肝2017年4月17日。doi：10.1111 / jvh.12717。 [提前印刷]
病毒性肝炎病因对肝细胞癌生存结局的影响：大型多中心队列研究。
Mgaieth S1，Kemp W1，Gow P2，Fink M3，Lubel J4，Nicoll A4,5，Gazzola A1，Hong T6，Ryan M6，Knight V7，Dev A7，Sood S5，Bell S6，Paul E8，Roberts SK1。
作者信息

1澳大利亚墨尔本阿尔弗雷德医院消化内科。
2澳大利亚墨尔本奥斯汀医院消化内科。
3澳大利亚海德堡奥斯汀医院外科。
4澳大利亚Box Hill Box Hill医院消化内科。
澳大利亚帕克维尔皇家墨尔本医院胃肠病学系5。
6澳大利亚Fitzroy圣文森特医院消化内科。
7澳大利亚克莱顿莫纳什医疗中心消化内科。
8澳大利亚墨尔本莫纳什大学流行病与预防医学系。

抽象
背景与目的：

虽然HBV和HCV是HCC的危险因素，但是这些病毒感染在HCC中是否具有预后意义仍然存在不确定性。因此，我们比较了HBV，HCV和非病毒性肝癌患者的总生存期，并评估了HBV和HCV的存在预测患者结局。
方法：

我们在二零零零年一月至十二月期间，在六间墨尔本三级医院诊断出的HCC病例进行了多中心研究。患者人口统计学，肝脏疾病和肿瘤特征以及患者结局均来自医院数据库，电脑记录和维多利亚死因登记处。比较HBV，HCV和非病毒性肝炎病例的生存结果和使用Cox比例风险回归确定的生存预测因子。
结果：

确定了1436例新发的HCC病例，包括病毒性肝炎（HBV 235，HCV 511，HBV-HCV 30）776例，非病毒性原因660例。 HBV，HCV和非病毒性HCC患者的中位生存期分别为59.1,28.4和20.9个月（P <0.0001）。在多变量分析中，存活的独立危险因素包括HCC病因，性别，BCLC期，血清AFP，病变总数和大小，血清肌酐和白蛋白。调查这些和检测方法后，与非病毒（HR 0.60,95％CI 0.35-0.98; P = 0.03）和HCV相关HCC（HR 0.51,95）相比，HBV仍然是改善总生存期的独立预测因子％CI 0.30-0.85; P = 0.01）。
结论：

在这项大型多中心研究中，与HCV和非病毒相关的HCC相比，HBV与总体生存率相提并论。需要进一步的研究来确定负责的潜在因素。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键词：

乙型肝炎丙型肝炎;肝细胞癌;生存

PMID：
    28414893
DOI：
    10.1111 / jvh.12717