High Hepatitis B Viral Load Predicts Recurrence of Small HCC

liver411

after Curative Resection

J Gastrointest Surg. 2010 Apr 27. [Epub ahead of print]

High Hepatitis B Viral Load Predicts Recurrence of Small Hepatocellular
Carcinoma after Curative Resection.

Qu LS, Jin F, Huang XW, Shen XZ.

Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan
University, 180# Fenglin Road, Shanghai, 200032, China.

Abstract
A retrospective cohort study was conducted to identify risk factors for
recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC)
after curative resection. A total of 317 patients who had received curative
resection of pathologically proven small HCC (</=3 cm in diameter) were
analyzed to ascertain the factors affecting recurrence. The median follow-up
period was 33.7 months. Cumulative recurrence rates at 1, 3, and 5 years after
resection were 23.5%, 49.5%, and 65.5%, respectively. Male sex,
alpha-fetoprotein (AFP)>/=400 ng/mL, HBV DNA level>/=4 log(10) copies/mL,
prolonged prothrombin time, tumor size>/=2 cm, microvascular invasion, absence
of capsular formation, moderate/poor tumor differentiation, and absence of
postoperative interferon-alpha (IFN-alpha) treatment were associated with
increased cumulative risk of HCC recurrence. By multivariate analysis, HBV DNA
level>/=4 log(10) copies/mL (P < 0.001, hazard ratio (HR) 2.110), AFP>/=400
ng/mL (P = 0.011, HR 1.574), microvascular invasion (P < 0.001, HR 1.767), and
postoperative IFN-alpha treatment (P = 0.022, HR 0.562) remained to be
independently associated with HCC recurrence. Those contributing to late
recurrence (>2 years) were older age and HBV DNA level>/=4 log(10) copies/mL.
Patients with persistent HBV DNA level>/=4 log(10) copies/mL at resection and
follow-up had the highest recurrence risk (P < 0.001, HR 4.129). HBV DNA
level>/=4 log(10) copies/mL at the time of resection was the most important
risk factor for recurrence. Postoperative IFN-alpha treatment significantly
decreased the recurrence risk after resection.

PMID: 20422305 [PubMed - as supplied by publisher

afang1989

肝病毒载量高的可预测复发的小肝癌
根治性切除后

J Gastrointest外科。 2010年4月27日。 [EPUB的提前打印]

乙肝病毒载量高的可预测复发的小肝癌
癌根治性切除后。

曲的LS，金女，黄唯，沉征。

胃肠病学和肝病学系，中山医院，复旦大学
大学，180＃枫林路，上海，200032，中国。

抽象
回顾性队列研究，以确定进行风险因素
复发的乙型肝炎病毒（HBV）的相关性肝癌（肝癌）
根治性切除后。阿谁收到的317例患者治疗
经病理证实小肝癌（</ = 3公分切除术）的
分析，以确定影响复发的因素。在中位随访
期为33.7个月。 1累积复发率，3，5年后
切除分别为23.5％，49.5％和65.5％，分别为。男性，
α-甲胎蛋白（AFP）> / = 400纳克/毫升，乙肝病毒DNA水平> / = 4日志（10）拷贝/毫升，
凝血酶原时间延长，肿瘤大小> / = 2厘米，微血管侵袭，不在
囊袋的形成，温和/肿瘤分化差，以及没有
术后干扰素-α（干扰素-α）治疗均与
累计增加肝癌复发的危险。通过多因素分析，乙肝病毒脱氧核糖核酸
一级> / = 4日志（10）拷贝/毫升性（P <0.001，危险比（HR）2.110），法新社> / = 400
纳克/毫升（P值0.011，人力资源1.574），微血管侵犯（P <0.001，人力资源1.767），和
术后干扰素-α组（P = 0.022，人力资源0.562）仍然是
与肝癌复发的独立相关。特别是有助于晚
复发（> 2年）的年龄和HBV DNA水平> / = 4日志（10）拷贝/毫升。
患者持续性HBV DNA水平> / = 4日志（10）拷贝/毫升，并在切除
后续有最高的复发风险（P <0.001，人力资源4.129）。乙型肝炎病毒DNA
一级> / = 4日志（10）拷贝/于切除时间毫升是最重要的
复发的危险因素。术后干扰素-α治疗显着