Ge Zhong, Ma Jian, Qiao Bing, Wang Yanling, Zhang Haifeng, Gou Wei
Department of Hepatobiliary-Pancreatic Surgery.
Department of Health Care, Qingdao Municipal Hospital, Qingdao University, Qingdao.
Medicine (Baltimore). 2020 Aug 7;99(32):e21454. doi: 10.1097/MD.0000000000021454.
The impact of different antiviral regimen on prognosis of chronic hepatitis B (CHB) related hepatocellular carcinoma (HCC) remains to be explored.A total of 479 CHB-related HCC patients after curative liver resection were enrolled receiving tenofovir (TDF, TDF group) or lamivudine, telbivudine, and entecavir (non-TDF group). Both the overall survival and diseases-free survival were analyzed and compared.A total of 242 patients received TDF treatment and 237 patients received other antiviral regimen. Child-Pugh score, serum α-fetoprotein (AFP) level, total bilirubin level, status of hepatitis B e antigen (HBeAg), and cirrhosis were compared between groups. Kaplan-Meier analysis revealed that patients with TDF treatment had significantly longer overall survival than those of patients with other regimen (P = .015). Similarly, compared with patients with non-TDF treatment, disease-free survival time was longer (P = .042) in those with TDF treatment. Multivariate analysis showed that TDF treatment (P = .04), AFP level (P = .03) were significant independent factors associated with overall survival of CHB-related HCC patients. While TDF treatment (P = .04) and serum AFP level (P = .03) were independent factors associated with disease-free survival.Anti-virus treatment with TDF benefits for both overall survival and disease-free survival of CHB-related patients than other Nucleos(t)ide analogues.
不同抗病毒方案对慢性乙型肝炎（CHB）相关肝细胞癌（HCC）预后的影响仍有待探索。共有479例接受根治性肝切除术后的CHB相关HCC患者入组，分别接受替诺福韦（TDF，TDF组）或拉米夫定、替比夫定和恩替卡韦治疗（非TDF组）。分析并比较了总生存期和无病生存期。共有242例患者接受TDF治疗，237例患者接受其他抗病毒方案。比较了两组之间的Child-Pugh评分、血清甲胎蛋白（AFP）水平、总胆红素水平、乙肝e抗原（HBeAg）状态和肝硬化情况。Kaplan-Meier分析显示，接受TDF治疗的患者总生存期显著长于接受其他方案治疗的患者（P = 0.015）。同样，与非TDF治疗的患者相比，接受TDF治疗的患者无病生存期更长（P = 0.042）。多因素分析表明，TDF治疗（P = 0.04）、AFP水平（P = 0.03）是与CHB相关HCC患者总生存期相关的显著独立因素。而TDF治疗（P = 0.04）和血清AFP水平（P = 0.03）是与无病生存期相关的独立因素。与其他核苷（酸）类似物相比，TDF抗病毒治疗对CHB相关患者的总生存期和无病生存期均有益。
