抗病毒治疗可改善乙肝相关肝细胞癌患者的术后生存。
Antiviral therapy improves postoperative survival of patients with HBV-related hepatocellular carcinoma.
机构信息
Department of Liver Surgery and Transplantation, Zhongshan Hospital, Fudan University, Liver Cancer Institute, Fudan University, Key Laboratory for Carcinogenesis & Cancer Invasion, The Chinese Ministry of Education, Shanghai, China.
Department of Liver Surgery and Transplantation, Zhongshan Hospital, Fudan University, Liver Cancer Institute, Fudan University, Key Laboratory for Carcinogenesis & Cancer Invasion, The Chinese Ministry of Education, Shanghai, China.
出版信息
Am J Surg. 2022 Jul;224(1 Pt B):494-500. doi: 10.1016/j.amjsurg.2022.01.008. Epub 2022 Jan 26.
BACKGROUND
We aimed to investigate whether improvements in the prognosis of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) who have undergone hepatectomy are associated with reductions in the liver inflammation and fibrosis by antiviral therapy (AVT).
METHODS
Patients who underwent hepatectomy and re-hepatectomy for HBV-related HCC between 2010 and 2019 were divided into two groups. Histological changes in liver were compared between initial and recurrence stages within each group. Propensity score matching (PSM) analysis was performed to compare prognostic outcomes.
RESULTS
After PSM, AVT group showed a significantly better prognosis than did non-AVT group (RFS: 19.1% vs. 5.8%, P = 0.001; OS: 64.0% vs. 43.2%, P < 0.001). The improvements in G and S were independent protective factors for RFS (G: P < 0.001; S: P < 0.001) and OS (G: P = 0.013; S: P < 0.001).
CONCLUSIONS
The application of AVT after initial surgery improved liver inflammation and fibrosis, further benefiting long-term outcomes of patients with HBV-related HCC.
背景
本研究旨在探讨抗病毒治疗（AVT）是否通过减轻肝内炎症和纤维化，改善行肝切除术的乙型肝炎病毒（HBV）相关肝细胞癌（HCC）患者的预后。
方法
将 2010 年至 2019 年期间行肝切除术和再次肝切除术治疗 HBV 相关 HCC 的患者分为两组。比较每组初始和复发阶段的肝组织学变化。采用倾向评分匹配（PSM）分析比较预后结果。
结果
PSM 后，AVT 组的预后明显优于非 AVT 组（RFS：19.1% vs. 5.8%，P=0.001；OS：64.0% vs. 43.2%，P<0.001）。G 和 S 的改善是 RFS（G：P<0.001；S：P<0.001）和 OS（G：P=0.013；S：P<0.001）的独立保护因素。
结论
初始手术后应用 AVT 可改善肝内炎症和纤维化，进一步有益于 HBV 相关 HCC 患者的长期预后。
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