Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.
Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.
World J Surg Oncol. 2019 Mar 1;17(1):45. doi: 10.1186/s12957-019-1577-9.
The effect of antiviral therapy (AVT) on clinical outcomes in patients with hepatocellular carcinoma (HCC) who are seronegative for hepatitis B virus (HBV), defined as HBV DNA < 100 IU/ml prior to surgical resection, is unknown. The main purpose of this study was to evaluate the possible value of AVT in this cohort of patients.
From January 2006 to January 2013, 161 HCC patients with positive serum tests for HBV surface antigen (HBsAg) but negative tests for HBV DNA who had undergone hepatectomy were included and analyzed. Propensity score matching (PSM) was used to balance the heterogeneity in baseline characteristics.
All patients were divided into the following two groups: the AVT group (n = 73, 45.34%) and the non-AVT group (n = 88, 54.66%). HBV reactivation occurred in 20 patients in the non-AVT group (22.73%) but in only 2 patients in the AVT group (2.74%, p < 0.001). After PSM, the 1-, 2-, and 3-year recurrence-free survival (RFS) rates in the AVT group and the non-AVT group were 78.38%, 72.97%, and 62.16% and 81.08%, 72.97%, and 72.97%, respectively (p = 0.564); the 1-, 2-, and 3-year overall survival (OS) rates were 97.30%, 97.3%, and 91.89% and 94.59%, 94.59%, and 86.49% in the AVT group and non-AVT group, respectively (p = 0.447).
Antiviral therapy can reduce HBV reactivation but is not correlated with a significant increase in postoperative RFS and OS in HCC patients with HBV DNA levels < 100 IU/ml.
对于乙型肝炎病毒（HBV）血清学阴性（定义为手术切除前 HBV DNA < 100IU/ml）的肝细胞癌（HCC）患者，抗病毒治疗（AVT）对临床结局的影响尚不清楚。本研究的主要目的是评估 AVT 在这部分患者中的可能价值。
2006 年 1 月至 2013 年 1 月，纳入并分析了 161 例 HBsAg 阳性但 HBV DNA 阴性的 HCC 患者，这些患者接受了肝切除术。采用倾向评分匹配（PSM）平衡基线特征的异质性。
所有患者均分为以下两组：AVT 组（n=73，45.34%）和非-AVT 组（n=88，54.66%）。非-AVT 组中有 20 例（22.73%）发生 HBV 再激活，而 AVT 组仅 2 例（2.74%，p<0.001）。PSM 后，AVT 组和非-AVT 组的 1、2、3 年无复发生存率（RFS）分别为 78.38%、72.97%和 62.16%和 81.08%、72.97%和 72.97%（p=0.564）；AVT 组和非-AVT 组的 1、2、3 年总生存率（OS）分别为 97.30%、97.3%和 91.89%和 94.59%、94.59%和 86.49%（p=0.447）。
抗病毒治疗可降低 HBV 再激活，但与 HBV DNA 水平<100IU/ml 的 HCC 患者术后 RFS 和 OS 的显著增加无关。
