Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Cancer. 2013 Jun 15;119(12):2239-46. doi: 10.1002/cncr.28082. Epub 2013 Apr 5.
Metastatic tumor antigen 1 (MTA1) overexpression is closely associated with postoperative recurrence of hepatocellular carcinoma (HCC). It has been suggested that pegylated interferon (Peg-IFN) can prevent the occurrence of HCC in patients who have chronic viral hepatitis. In this study, the authors examined whether postoperative adjuvant Peg-IFN therapy can reduce the recurrence of MTA1-positive HCC after curative surgical resection.
In this case-control study, 93 patients with MTA1-positive HCC who underwent curative surgical resection were prospectively enrolled. The median patient age was 53 years (range, 27-78); there were 65 men and 28 women; the etiology was hepatitis B virus (HBV) in 77 patients, hepatitis C virus (HCV) in 6 patients, and non-HBV/non-HCV in 10 patients; 31 patients received Peg-IFN (Peg-INTRON) subcutaneously at a dose of 50 μg per week for 12 months (the Peg-IFN group); and the remaining 62 patients were followed only and did not receive any adjuvant therapies (control group). Patients were followed every 1 to 3 months for a median of 24 months.
HCC recurred postoperatively in 26 of 93 patients (28%), and 9 patients (10%) died during follow-up. The overall cumulative recurrence rates were significantly lower in the Peg-IFN group than in the control group (7% and 14% vs. 24% and 34% at 1 year and 2 years, respectively; P < .05). In addition, the 1-year and 2-year cumulative survival rates were higher in the Peg-IFN group compared with the control group (100% vs. 93% and 100% vs. 87%, respectively; P < .05). In multivariate analysis, the receipt of adjuvant Peg-IFN therapy, in addition to having a lower Cancer of the Liver Italian Program score and being a woman, was an independent, favorable factor for a lower risk of postoperative recurrence.
The current data indicate that adjuvant Peg-IFN therapy may reduce the recurrence of HCC in patients who have MTA1-positive HCC after curative surgical resection.
转移肿瘤抗原 1（MTA1）过表达与肝细胞癌（HCC）术后复发密切相关。已有研究表明聚乙二醇干扰素（Peg-IFN）可预防慢性病毒性肝炎患者发生 HCC。本研究旨在探讨术后辅助 Peg-IFN 治疗是否能降低 MTA1 阳性 HCC 根治性切除术后的复发率。
本病例对照研究前瞻性纳入 93 例 MTA1 阳性 HCC 患者，均接受根治性手术切除。中位患者年龄为 53 岁（范围：27-78 岁）；男性 65 例，女性 28 例；病因：乙型肝炎病毒（HBV）77 例，丙型肝炎病毒（HCV）6 例，非 HBV/非 HCV 10 例；31 例患者接受每周皮下注射 50μg Peg-IFN（Peg-INTRON），共 12 个月（Peg-IFN 组）；其余 62 例仅进行随访，不接受任何辅助治疗（对照组）。中位随访时间 24 个月，每 1-3 个月随访 1 次。
93 例患者中 26 例（28%）术后 HCC 复发，9 例（10%）患者随访期间死亡。Peg-IFN 组的总累积复发率明显低于对照组（1 年和 2 年时分别为 7%和 14%，24%和 34%；P<0.05）。此外，Peg-IFN 组的 1 年和 2 年累积生存率均高于对照组（100%比 93%，100%比 87%；P<0.05）。多因素分析显示，辅助 Peg-IFN 治疗，除了较低的意大利肝癌项目评分和女性外，是降低术后复发风险的独立有利因素。
本研究数据表明，对于 MTA1 阳性 HCC 根治性切除术后的患者，辅助 Peg-IFN 治疗可能降低 HCC 的复发率。
