Division of General Surgery, Department of Surgery, Kaohsiung Veteran General Hospital, Kaohsiung, Taiwan.
J Am Coll Surg. 2010 Nov;211(5):580-6. doi: 10.1016/j.jamcollsurg.2010.06.020. Epub 2010 Sep 20.
Genotype B and C are the predominant hepatitis B virus (HBV) strains in Taiwan. We aimed to investigate the role of genotype in HBV-related hepatocellular carcinoma (HCC) after resection.
From October 2005 to November 2008, 64 patients who underwent liver resection for HBV-related HCC were enrolled. HBV genotypes were determined by molecular method. Patient characteristics, biochemical, tumor, and viral factors were evaluated for their prognostic significance.
During a mean follow-up of 26.6 ± 13.2 months, patients infected with genotype C had higher HBV viral load (p = 0.007) and worse disease-free survival rate (p = 0.028) than patients with genotype B. By univariate analysis, genotype C, alanine transaminase >50 U/L, tumor size ≥5 cm, and microvascular invasion were associated with tumor recurrence. Further multivariate analysis demonstrated genotype C remained a significant risk factor (p = 0.034).
Genotype C is a strong risk factor for HCC recurrence after resection. More intensive monitoring for recurrence should be considered in patients with genotype C.
B 型和 C 型肝炎病毒（HBV）是台湾地区的主要 HBV 株。本研究旨在探讨基因型在 HBV 相关肝细胞癌（HCC）切除术后的作用。
2005 年 10 月至 2008 年 11 月，我们共纳入 64 例因 HBV 相关 HCC 而行肝切除术的患者。采用分子生物学方法确定 HBV 基因型。评估患者的特征、生化、肿瘤和病毒因素，以评估其预后意义。
在平均 26.6±13.2 个月的随访期间，与 B 型基因型患者相比，C 型基因型患者的 HBV 病毒载量更高（p=0.007），无疾病生存率更差（p=0.028）。单因素分析显示，C 型基因型、丙氨酸氨基转移酶（ALT）＞50 U/L、肿瘤直径≥5cm 和微血管侵犯与肿瘤复发相关。进一步的多因素分析表明，C 型基因型仍然是一个显著的危险因素（p=0.034）。
C 型基因型是 HCC 切除术后肿瘤复发的一个强烈危险因素。对于 C 型基因型的患者，应更密切地监测复发情况。
