Department of Gastroenterology and Hematology, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
J Gastroenterol. 2009;44(9):991-9. doi: 10.1007/s00535-009-0093-z. Epub 2009 Jun 25.
Prediction and prevention of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) recurrence is an important clinical issue. We investigated whether HBV DNA level and antiviral therapy are associated with HCC recurrence.
This retrospective study involved 103 patients who underwent hepatic resection or radiofrequency ablation for initial HCC. Patients were divided into four groups. Thirty had high serum HBV DNA levels (>4 log(10) copies/mL) and had not received antiviral therapy (high virus group; HVG). Thirty-four had low HBV DNA levels (< or =4 log(10) copies/mL) and had not received antiviral therapy (low virus group; LVG). Twenty received antiviral therapy after HCC developed (therapeutic group A, TG-A). Nineteen received antiviral therapy before HCC developed (therapeutic group B, TG-B).
Cumulative HCC recurrence rates at 3 years in the HVG, LVG, TG-B, and TG-A were 71.1%, 42.2%, 42.3%, and 52.0%, respectively. Recurrence rates differed significantly between the HVG and LVG (P = 0.016) and between the HVG and TG-B (P = 0.008). Recurrence rate in the TG-A was marginally lower than in the HVG (P = 0.10). On multivariate analysis, high serum hepatitis B virus DNA levels (hazard ratio: HR 2.67; 95% CI 1.31-5.47; P = 0.007) and absence of antiviral therapy (HR 2.57; 95% CI 1.34-4.94; P = 0.005) were independent risk factors for hepatocellular carcinoma recurrence.
HBV DNA level and antiviral therapy are associated with HCC recurrence. For patients with high HBV DNA levels, antiviral therapy before the development of HCC is important for prevention of recurrence.
乙型肝炎病毒（HBV）相关肝细胞癌（HCC）复发的预测和预防是一个重要的临床问题。我们研究了 HBV DNA 水平和抗病毒治疗是否与 HCC 复发有关。
本回顾性研究纳入了 103 例因初始 HCC 而行肝切除术或射频消融术的患者。患者被分为四组。30 例患者血清 HBV DNA 水平较高（>4 log(10) 拷贝/ml）且未接受抗病毒治疗（高病毒组；HVG）。34 例患者 HBV DNA 水平较低（<或=4 log(10) 拷贝/ml）且未接受抗病毒治疗（低病毒组；LVG）。20 例患者在 HCC 发生后接受抗病毒治疗（治疗组 A，TG-A）。19 例患者在 HCC 发生前接受抗病毒治疗（治疗组 B，TG-B）。
HVG、LVG、TG-B 和 TG-A 组患者的 HCC 累积复发率在 3 年内分别为 71.1%、42.2%、42.3%和 52.0%。HVG 与 LVG 之间（P = 0.016）和 HVG 与 TG-B 之间（P = 0.008）的复发率差异有统计学意义。TG-A 组的复发率略低于 HVG 组（P = 0.10）。多因素分析显示，高血清乙型肝炎病毒 DNA 水平（危险比：2.67；95%可信区间：1.31-5.47；P = 0.007）和未接受抗病毒治疗（危险比：2.57；95%可信区间：1.34-4.94；P = 0.005）是 HCC 复发的独立危险因素。
HBV DNA 水平和抗病毒治疗与 HCC 复发有关。对于 HBV DNA 水平较高的患者，在 HCC 发生前进行抗病毒治疗对于预防复发很重要。
