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HBV 感染降低结直肠癌患者肝转移的风险:一项队列研究。

HBV infection decreases risk of liver metastasis in patients with colorectal cancer: A cohort study.

机构信息

State Key Laboratory of Oncology in South China, Guangzhou 510060, Guangdong Province, China.

出版信息

World J Gastroenterol. 2011 Feb 14;17(6):804-8. doi: 10.3748/wjg.v17.i6.804.

Abstract

AIM

To evaluate the effect of hepatitis B virus (HBV) infection on liver metastasis of colorectal cancer.

METHODS

A total of 1298 colorectal cancer patients were recruited from January 2001 to March 2005 in this study. Enzyme-linked immunosorbent assay was used to test serum HBV markers for colorectal cancer. Patients were divided into study (infection) group and control (non-infection) group. Clinical features of patients in two groups were compared.

RESULTS

Liver metastasis was found in 319 out of the 1298 colorectal cancer patients. The incidence of liver metastasis was significantly lower in study group than in control group (14.2% vs 28.2%, P < 0.01). HBV infection significantly decreased the risk of liver metastasis [hazard ratio (HR): 0.50, 95% confidence interval (95% CI): 0.38-0.66], but the incidence of extrahepatic metastasis was significantly higher in study group than in control group (31.9% vs 17.0%, P < 0.01). The HR was the lowest in chronic hepatitis B group (HR: 0.29, 95% CI: 0.12-0.72). The number of liver metastatic lesions was significantly less in study group than in control group with a higher surgical resection rate. However, no significant difference was found in survival rate between the two groups (P = 0.95).

CONCLUSION

HBV infection decreases the risk of liver metastasis in patients with colorectal cancer and elevates the surgical resection rate of liver metastatic lesions.

摘要

目的

评估乙型肝炎病毒(HBV)感染对结直肠癌肝转移的影响。

方法

本研究共纳入 1298 例结直肠癌患者,均为 2001 年 1 月至 2005 年 3 月间接受治疗。采用酶联免疫吸附试验检测结直肠癌患者血清 HBV 标志物。将患者分为研究(感染)组和对照组(非感染)。比较两组患者的临床特征。

结果

在 1298 例结直肠癌患者中,319 例发生肝转移。研究组肝转移发生率明显低于对照组(14.2%比 28.2%,P < 0.01)。HBV 感染显著降低了肝转移的风险[风险比(HR):0.50,95%置信区间(95%CI):0.38-0.66],但研究组肝外转移发生率明显高于对照组(31.9%比 17.0%,P < 0.01)。在慢性乙型肝炎组中,HR 最低(HR:0.29,95%CI:0.12-0.72)。研究组的肝转移灶数量明显少于对照组,手术切除率更高。然而,两组患者的生存率无显著差异(P = 0.95)。

结论

HBV 感染降低了结直肠癌患者肝转移的风险,提高了肝转移灶的手术切除率。

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