Xiao Weikai, Zhou Ying, Yu Ping, Yang Anli, Zheng Shaoquan, Tang Hailin, Xie Xiaoming
Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
Ann Transl Med. 2020 Mar;8(5):180. doi: 10.21037/atm.2020.01.97.
Except for hepatocellular carcinoma, chronic hepatitis B virus (HBV) infection has also been reported to be associated with increased morbidity and mortality of other cancers. However, the impact of chronic HBV infection on the prognosis of breast cancer (BC) remains unclear. Our study aimed to evaluate the prognostic value of HBV infection for BC in an endemic area of HBV in China.
There was a total of 1,904 patients with early BC who underwent mastectomy or breast-conserving surgery enrolled in our study. HBV infection on overall survival (OS) and hepatic metastasis-free survival (HMFS) was the main research indicator for this study.
A total of 212 patients (11.1%) were identified with chronic HBV infection due to serum hepatitis B surface antigen (HBsAg) positive. HBsAg-positive patients had inferior OS (84.9% . 90.4%, P=0.005) and HMFS (92.5% . 97.1%, P=0.016) at 5 years than HBsAg-negative patients. Chronic HBV infection was an independent predictor of poor OS in patients with BC [multivariate analysis; hazard ratio (HR), 1.52; P=0.038], but not for HMFS. Subgroup analysis showed that chronic HBV infection was an unfavorable independent prognostic factor for OS in patients with stage II/III BC (HR, 1.59; P=0.025). The 5-year OS and HMFS rates of HBsAg-positive patients were 81.9% and 90.5% for patients with stage II/III BC, while those rates of HBsAg-negative patients were 88.5% and 96.3%, respectively. In stage I patients, there was no significant difference in 5-year OS (95.8% . 97.1%; P=0.629) and HMFS (100.0% . 99.0%; P=0.447).
In conclusion, chronic HBV infection predicts a worse prognosis in patients with stage II/III BC, but not stage I BC.
除肝细胞癌外，慢性乙型肝炎病毒（HBV）感染也被报道与其他癌症的发病率和死亡率增加有关。然而，慢性HBV感染对乳腺癌（BC）预后的影响仍不清楚。我们的研究旨在评估在中国HBV流行地区HBV感染对BC的预后价值。
共有1904例接受乳房切除术或保乳手术的早期BC患者纳入我们的研究。HBV感染对总生存期（OS）和无肝转移生存期（HMFS）的影响是本研究的主要研究指标。
共有212例患者（11.1%）因血清乙型肝炎表面抗原（HBsAg）阳性而被确诊为慢性HBV感染。HBsAg阳性患者5年时的OS（84.9%对90.4%，P=0.005）和HMFS（92.5%对97.1%，P=0.016）均低于HBsAg阴性患者。慢性HBV感染是BC患者OS不良的独立预测因素[多因素分析；风险比（HR），1.52；P=0.038]，但对HMFS不是。亚组分析显示，慢性HBV感染是II/III期BC患者OS的不良独立预后因素（HR，1.59；P=0.025）。II/III期BC患者中，HBsAg阳性患者的5年OS率和HMFS率分别为81.9%和90.5%，而HBsAg阴性患者的相应比率分别为88.5%和96.3%。在I期患者中，5年OS（95.8%对97.1%；P=0.629）和HMFS（100.0%对99.0%；P=0.447）无显著差异。
总之，慢性HBV感染预示着II/III期BC患者预后较差，但I期BC患者并非如此。
