Qiu Jing-Feng, Ye Jia-Zhou, Feng Xu-Zhuo, Qi Ya-Peng, Ma Liang, Yuan Wei-Ping, Zhong Jian-Hong, Zhang Zhi-Ming, Xiang Bang-De, Li Le-Qun
Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
J Surg Oncol. 2017 Aug;116(2):140-148. doi: 10.1002/jso.24628. Epub 2017 Jun 19.
To investigate pre- and post-operative levels of HBsAg influence prognosis of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative resection.
Medical records were retrospectively analyzed for 881 patients with HBV-related HCC treated by curative resection. Patients were classified as having high or low serum HBsAg levels (≥200 or <200 ng/mL) pre- or post-operatively.
OS and RFS were better for patients with low pre-operative serum levels of HBsAg than for those with high levels. Similarly, OS was better among patients with low post-operative serum levels of HBsAg than among those with high levels. RFS, in contrast, was similar between these two groups. After generating propensity score-matched pairs of patients, OS was higher in patients with falling post-operative HBsAg levels than in those with rising levels. In contrast, RFS was similar between these two groups. Antiviral nucleoside analog therapy prolonged OS in patients with high pre-operative HBsAg levels.
Low pre- and post-operative levels of HBsAg may be associated with better long-term survival in patients with HBV-related HCC. Pre-operative serum levels of HBsAg ≥200 ng/mL may identify patients more likely to benefit from antiviral treatment.
探讨术前和术后乙肝表面抗原（HBsAg）水平对乙肝病毒（HBV）相关肝细胞癌（HCC）患者根治性切除术后预后的影响。
回顾性分析881例接受根治性切除的HBV相关HCC患者的病历。根据术前或术后血清HBsAg水平高或低（≥200或<200 ng/mL）对患者进行分类。
术前血清HBsAg水平低的患者总生存期（OS）和无复发生存期（RFS）优于水平高的患者。同样，术后血清HBsAg水平低的患者OS优于水平高的患者。相比之下，两组之间的RFS相似。在生成倾向评分匹配的患者对后，术后HBsAg水平下降的患者OS高于水平上升的患者。相比之下，两组之间的RFS相似。抗病毒核苷类似物治疗可延长术前HBsAg水平高的患者的OS。
术前和术后低水平的HBsAg可能与HBV相关HCC患者更好的长期生存相关。术前血清HBsAg水平≥200 ng/mL可能识别出更有可能从抗病毒治疗中获益的患者。
