围手术期抗病毒治疗可改善HBV相关肝细胞癌的HBV DNA阴性患者

StephenW

Perioperative antiviral therapy improves the prognosis of HBV DNA-negative patients with HBV-related hepatocellular carcinoma
Chuan Li , Zhi-Cheng Li , Liang Ma , Le-Qun Li , Jian-Hong Zhong ORCID Icon, Bang-De Xiang & show all
Received 27 Mar 2020, Accepted 16 Jun 2020, Accepted author version posted online: 18 Jun 2020

    Download citation https://doi.org/10.1080/17474124.2020.1784727 CrossMark Logo CrossMark


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Abstract
Objective

To investigate the effect of perioperative antiviral therapy on the prognosis of hepatitis B virus (HBV) DNA-negative patients with HBV-related hepatocellular carcinoma (HCC).
Methods

The clinical data of 140 patients who were positive for hepatitis B surface antigen (HBsAg) but negative for HBV DNA before partial hepatectomy were retrospectively analyzed. Patients who received perioperaive antiviral therapy were divided into the antiviral therapy group, and those who did not receive any antiviral therapies were divided into the non-antiviral therapy group. Propensity score matching (PSM) was used to match patients 1:1 to eliminate the influence of confounding factors on prognosis. Postoperative liver function, HBV reactivation rate, recurrence-free survival (RFS) and overall survival (OS) were compared between the two groups. After excluding patients with HBV reactivation, the prognostic analysis of the samples was conducted again, and then to observe whether perioperative antiviral therapy was effective for these patients who did not have HBV reactivation after partial hepatectomy.
Results

A total of 140 patients were included in this study, including 60 in the antiviral therapy group and 80 in the non-antiviral therapy group. Compared with the non-antiviral therapy group, the antiviral therapy group had a lower rate of HBV reactivation and better postoperative liver function (P < 0.05). The 1-year, 2-year and 3-year survival rates of the antiviral therapy group were better than those of the non-antiviral therapy group before or after PSM (P < 0.05). Prognostic analysis excluding 11 patients with HBV reactivation showed that perioperative antiviral therapy could significantly improve OS (P = 0.004), but had no significant effect on RFS (P = 0.056). Multivariate analyses showed that microvascular invasion (MVI) was the only independent risk factor for tumor recurrence, and antiviral therapy was associated with OS.
Conclusion

Perioperative antiviral therapy can significantly reduce the risk of HBV reactivation and improve postoperative liver function, and also significantly improve RFS and OS.
Keywords: Hepatocellular carcinoma, Hepatectomy, Prognosis, Overall survival, Hepatitis B, HBV DNA
Additional information
Funding
This work was funded by the Guangxi Natural Science Foundation (14124003-4), the National Science and Technology Major Special Project (2017ZX10203207), the National Natural Science Foundation of China (81160262, 81260088), the Guangxi Medical and Health Appropriate Technology Development and Promotion Application Project (S2019045), the Self-Raised Scientific Research Fund of the Ministry of Health of Guangxi Province (grant number Z2015601), and the ‘Guangxi BaGui Scholars’ Special Fund.
Authors’ contributions

W Gong and B Xiang conceived the study. C Li and Z Li collected and analyzed the data. C Li drafted the manuscript. L Ma, B Xiang, J Zhong and L Li critically revised the manuscript. All authors have read and approved the final version to be published.
Conflicts of Interest

The authors have declared that no competing interests exist.
Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to

disclose.

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StephenW

围手术期抗病毒治疗可改善HBV相关肝细胞癌的HBV DNA阴性患者的预后
李川，李志成，马良，李乐群，钟建宏ORCID Icon，向德德＆显示全部
于2020年3月27日收到，于2020年6月16日接受，在网上发布的作者版本为：2020年6月18日

    下载引文https://doi.org/10.1080/17474124.2020.1784727 CrossMark徽标CrossMark


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目的

目的探讨围手术期抗病毒治疗对乙肝病毒相关肝细胞癌（HCC）的乙肝病毒（HBV）DNA阴性患者的预后的影响。
方法

回顾性分析140例部分肝切除术前乙型肝炎表面抗原（HBsAg）阳性但HBV DNA阴性的患者的临床资料。接受围手术期抗病毒治疗的患者分为抗病毒治疗组，未接受任何抗病毒治疗的患者分为非抗病毒治疗组。倾向得分匹配（PSM）用于按1：1比例匹配患者，以消除混杂因素对预后的影响。比较两组的术后肝功能，HBV激活率，无复发生存率（RFS）和总生存率（OS）。在排除了HBV复活的患者后，再次进行样品的预后分析，然后观察围手术期抗病毒治疗对于部分肝切除术后没有HBV复活的患者是否有效。
结果

本研究共纳入140例患者，其中抗病毒治疗组60例，非抗病毒治疗组80例。与非抗病毒治疗组相比，抗病毒治疗组的HBV再生率较低，术后肝功能较好（P <0.05）。 PSM前后，抗病毒治疗组的1年，2年和3年生存率优于非抗病毒治疗组（P <0.05）。排除11例HBV复活患者的预后分析表明，围手术期抗病毒治疗可以显着改善OS（P = 0.004），但对RFS无显着影响（P = 0.056）。多变量分析表明，微血管浸润是肿瘤复发的唯一独立危险因素，抗病毒治疗与OS相关。
结论

围手术期抗病毒治疗可以显着降低HBV再次激活的风险，改善术后肝功能，还可以显着改善RFS和OS。
关键词：肝细胞癌，肝切除术，预后，总体生存率，乙型肝炎，HBV DNA
附加信息
资金
这项工作由广西自然科学基金（14124003-4），国家科学技术重大专项（2017ZX10203207），国家自然科学基金（81160262、81260088），广西医疗卫生适当技术开发和研究中心资助推广应用项目（S2019045），广西省卫生部自筹科研基金（授权号Z2015601）和“广西八桂学者专项资金”。
作者的贡献

龚W和B向设想了这项研究。 C Li和Z Li收集并分析了数据。 C Li起草了手稿。 L Ma，B B Xiang，J J Zhong和L Li对原稿进行了严格的修改。所有作者均已阅读并批准了最终版本。
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作者宣称不存在任何竞争利益。
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作者与手稿中讨论的主题或材料有经济利益或与之有财务利益的任何组织或实体没有任何从属关系或财务往来。这包括就业，咨询，酬金，股权或期权，专家证词，已收到或正在申请的赠款或专利或特许权使用费。
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挚友888888

A total of 140 patients were included in this study, including 60 in the antiviral therapy group and 80 in the non-antiviral therapy group. Compared with the non-antiviral therapy group, the antiviral therapy group had a lower rate of HBV reactivation and better postoperative liver function (P < 0.05). The 1-year, 2-year and 3-year survival rates of the antiviral therapy group were better than those of the non-antiviral therapy group before or after PSM (P < 0.05). Prognostic analysis excluding 11 patients with HBV reactivation showed that perioperative antiviral therapy could significantly improve OS (P = 0.004), but had no significant effect on RFS (P = 0.056). Multivariate analyses showed that microvascular invasion (MVI) was the only independent risk factor for tumor recurrence, and antiviral therapy was associated with OS.

挚友888888

The 1-year, 2-year and 3-year survival 抗病毒治疗组的1年，2年和3年生存率，失败以后还可以换药吗？还是game is over。