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隐匿性乙型肝炎病毒感染与非B、非C型肝细胞癌根治性切除患者的手术结局

Occult hepatitis B virus infection and surgical outcomes in non-B, non-C patients with curative resection for hepatocellular carcinoma.

作者信息

Koga Hiroki, Kai Keita, Aishima Shinichi, Kawaguchi Atsushi, Yamaji Koutaro, Ide Takao, Ueda Junji, Noshiro Hirokazu

机构信息

Department of Surgery, Saga University Faculty of Medicine, Saga 849-8501, Japan.

Department of Pathology, Saga University Hospital, Saga 849-8501, Japan.

出版信息

World J Hepatol. 2017 Dec 18;9(35):1286-1295. doi: 10.4254/wjh.v9.i35.1286.

Abstract

AIM

To investigate the prevalence, clinicopathological characteristics and surgical outcomes of occult hepatitis B virus (HBV) infection (OBI) in patients with non-B, non-C (NBNC) hepatocellular carcinoma (HCC).

METHODS

This study retrospectively examined the cases of 78 NBNC patients with curative resection for HCC for whom DNA could be extracted from formalin-fixed paraffin-embedded tissue. OBI was determined by the HBV-DNA amplification of at least two different sets of primers by TaqMan real-time polymerase chain reaction. Possibly carcinogenetic factors such as alcohol abuse, diabetes mellitus, obesity and non-alcoholic steatohepatitis (NASH) were examined. Surgical outcomes were evaluated according to disease-free survival (DFS), overall survival (OS) and disease-specific survival (DSS).

RESULTS

OBI was found in 27/78 patients (34.6%) with NBNC HCC. The OBI patients were significantly younger than the non-OBI cases at the time of surgery (average age 63.0 68.1, = 0.0334) and the OBI cases overlapped with other etiologies significantly more frequently compared to the non-OBI cases ( = 0.0057). OBI had no impact on the DFS, OS or DSS. Only tumor-related factors affected these surgical outcomes.

CONCLUSION

Our findings indicate that OBI had no impact on surgical outcomes. The surgical outcomes of NBNC HCC depend on early tumor detection; this reconfirms the importance of a periodic medical examination for individuals who have NBNC HCC risk factors.

摘要

目的

探讨非B、非C型(NBNC)肝细胞癌(HCC)患者隐匿性乙型肝炎病毒(HBV)感染(OBI)的患病率、临床病理特征及手术疗效。

方法

本研究回顾性分析了78例接受HCC根治性切除术且可从福尔马林固定石蜡包埋组织中提取DNA的NBNC患者的病例。通过TaqMan实时聚合酶链反应,采用至少两组不同引物进行HBV-DNA扩增来确定OBI。检测可能的致癌因素,如酗酒、糖尿病、肥胖和非酒精性脂肪性肝炎(NASH)。根据无病生存期(DFS)、总生存期(OS)和疾病特异性生存期(DSS)评估手术疗效。

结果

78例NBNC HCC患者中,27例(34.6%)发现存在OBI。手术时,OBI患者明显比非OBI患者年轻(平均年龄63.0对68.1,P = 0.0334),与非OBI患者相比,OBI患者与其他病因重叠的频率明显更高(P = 0.0057)。OBI对DFS、OS或DSS无影响。只有肿瘤相关因素影响这些手术疗效。

结论

我们的研究结果表明,OBI对手术疗效无影响。NBNC HCC的手术疗效取决于早期肿瘤检测;这再次证实了对有NBNC HCC危险因素的个体进行定期体检的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/086f/5740092/017495f0a45e/WJH-9-1286-g001.jpg

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