Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University , Nanning, China.
Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center , Nanning, China.
Expert Rev Gastroenterol Hepatol. 2020 Aug;14(8):749-756. doi: 10.1080/17474124.2020.1784727. Epub 2020 Jun 30.
To investigate the effect of perioperative antiviral therapy on the prognosis of hepatitis B virus (HBV) DNA-negative patients with HBV-related hepatocellular carcinoma (HCC).
The clinical data of 140 patients who were positive for hepatitis B surface antigen (HBsAg) but negative for HBV DNA before partial hepatectomy were retrospectively analyzed. Propensity score matching (PSM) was used to eliminate the influence of confounding factors on prognosis. Postoperative liver function, HBV reactivation rate, recurrence-free survival (RFS) and overall survival (OS) were compared between antiviral and non-antiviral therapy groups.
Compared with the non-antiviral therapy group, the antiviral therapy group had a lower rate of HBV reactivation and better postoperative liver function (P < 0.05). The 1-year, 2-year and 3-year survival rates of the antiviral therapy group were better than those of the non-antiviral therapy group before or after PSM (P < 0.05). Prognostic analysis excluding 11 patients with HBV reactivation showed that perioperative antiviral therapy could significantly improve OS (P = 0.004), but had no significant effect on RFS (P = 0.056). Multivariate analyzes showed that antiviral therapy was associated with better OS.
Perioperative antiviral therapy can significantly reduce the risk of HBV reactivation and improve postoperative liver function, RFS and OS.
研究围手术期抗病毒治疗对 HBV 相关肝细胞癌（HCC）HBV DNA 阴性患者预后的影响。
回顾性分析 140 例术前 HBsAg 阳性但 HBV DNA 阴性的行部分肝切除术患者的临床资料。采用倾向性评分匹配（PSM）消除预后混杂因素的影响。比较抗病毒治疗组与非抗病毒治疗组术后肝功能、HBV 再激活率、无复发生存率（RFS）和总生存率（OS）。
与非抗病毒治疗组相比，抗病毒治疗组 HBV 再激活率较低，术后肝功能较好（P<0.05）。抗病毒治疗组在 PSM 前后的 1 年、2 年和 3 年生存率均优于非抗病毒治疗组（P<0.05）。排除 11 例 HBV 再激活患者的预后分析显示，围手术期抗病毒治疗可显著提高 OS（P=0.004），但对 RFS 无显著影响（P=0.056）。多因素分析显示，抗病毒治疗与更好的 OS 相关。
围手术期抗病毒治疗可显著降低 HBV 再激活风险，改善术后肝功能、RFS 和 OS。
