Yang Yue, Song Lijie, Cao Jingyu, Liu Jing, Wang Dongxu, Wong Linda L, Zhao Lei
Shandong First Medical University and Shandong Academy of Medical Sciences, 6699 Qingdao road, Huaiyin District, Jinan, China.
Department of Hepatobiliary Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan road, Huaiyin District, Jinan, China.
J Cancer. 2021 Jan 1;12(5):1398-1405. doi: 10.7150/jca.51233. eCollection 2021.
A considerable part of colorectal cancer (CRC) patients also have chronic hepatitis B (CHB), esp. in Asia. The effect of concomitant active CHB on the hazard of colorectal liver metastasis (CRLM) remains unclear. To evaluate the effect of concomitant active CHB on the risk of CRLM. The medical record of all newly diagnosed CRC patients who were hospitalized to the three hospitals between January 2010 to January 2016 were reviewed, the prevalence of synchronous CRLM (synCRLM) were retrospectively studied. Totally 7187 cases of newly diagnosed CRC, including 368 cases with concomitant CHB were recruited. The prevalence of synCRLM in HBsAg/HBeAg patients was compared to that in HBsAg/HBeAg patients. Significant risk factors for synCRLM were analyzed by logistic regression analysis. The overall prevalence of synCRLM was 8.72% (627/7187) and was significantly higher in HBsAg+ patients (43/368) than HBsAg- patients (576/6742) (11.68% vs. 8.54%, P=0.037; χ test).In 368 HBsAg patients, 365 patients also had HBeAg information. synCRLM was also more prevalent inHBsAg/HBeAg patients (13/69) compared to HBsAg/HBeAg patients (30/296) (18.84% 10.14%, =0.043; test). In univariate and multivariate logistic regression analysis, HBeAg positivity was the second strongest predictor of synCRLM (multivariate: OR, 2.622, =0.020) after CEA. (univariate: OR, 2.920, =0.001). HBeAg positivity is a clinical risk factor for CRLM that can be readily identified and addressed. Whether anti-CHB treatment can decrease the risk of CRLM worth carefully-designed prospective trials to define.
相当一部分结直肠癌（CRC）患者同时患有慢性乙型肝炎（CHB），尤其是在亚洲。合并活动性CHB对结直肠癌肝转移（CRLM）风险的影响尚不清楚。为评估合并活动性CHB对CRLM风险的影响，我们回顾了2010年1月至2016年1月期间在三家医院住院的所有新诊断CRC患者的病历，对同时性CRLM（synCRLM）的患病率进行了回顾性研究。共纳入7187例新诊断的CRC患者，其中368例合并CHB。比较了HBsAg/HBeAg阳性患者与HBsAg/HBeAg阴性患者中synCRLM的患病率。通过逻辑回归分析synCRLM的显著危险因素。synCRLM的总体患病率为8.72%（627/7187），HBsAg阳性患者（43/368）中的患病率显著高于HBsAg阴性患者（576/6742）（11.68%对8.54%，P=0.037；χ检验）。在368例HBsAg阳性患者中，365例患者也有HBeAg信息。与HBsAg/HBeAg阴性患者（30/296）相比，HBsAg/HBeAg阳性患者（13/69）中synCRLM也更常见（18.84%对10.14%，P=0.043；χ检验）。在单因素和多因素逻辑回归分析中，HBeAg阳性是继CEA之后synCRLM的第二强预测因素（多因素：OR，2.622，P=0.020）（单因素：OR，2.920，P=0.001）。HBeAg阳性是CRLM的一个临床危险因素，可容易识别和处理。抗CHB治疗是否能降低CRLM风险值得通过精心设计的前瞻性试验来确定。
