肝组织中HBsAg表达对微创介入治疗后肝细胞癌预后的影响
Effect of HBsAg expression in liver tissue on prognosis of hepatocellular carcinoma after minimally invasive interventional therapy.
作者信息
Liu Biyu, Wang Qi, Mei Tingting, Zheng Jiasheng, Gao Wenfeng, Yuan Chunwang, Li Kang, Zhang Yonghong
机构信息
Research Center For Biomedical Resources, Beijing You'an Hospital, Capital Medical University, Beijing, China.
Interventional Therapy Center For Oncology, Beijing You'an Hospital, Capital Medical University, Beijing, China.
出版信息
Front Oncol. 2023 Mar 9;13:1106333. doi: 10.3389/fonc.2023.1106333. eCollection 2023.
BACKGROUND
The aim of this study was to investigate the association between pathologic markers and prognosis in patients with hepatocellular carcinoma who received transcatheter chemoembolization combined with locoregional ablation therapy.
METHODS
This retrospective study included 111 hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC). All patients underwent transcatheter arterial chemoembolization (TACE) combined with locoregional ablation therapy, and received core needle biopsy before therapy in Beijing You 'an Hospital affiliated to Capital Medical University from January 1, 2013 to December 31, 2016. Demographic, pathological indicators and clinical laboratory data were collected. The cumulative recurrence-free survival (RFS) and overall survival (OS) were calculated and compared by Kaplan-Meier method and Log-rank test, and Cox proportional risk model was used to screen for independent predictors of recurrence and long-term prognosis in HCC patients.
RESULTS
There was a correlation between HBsAg expression in liver tissue and prognosis of HCC patients. Patients with negative HBsAg expression had longer 1-,3- and 5-year RFS rates than positive HBsAg expression (78.3%, 43.5%, 30.4% and 58.5%, 24.5%, 17.0%, P=0.018). Meanwhile,the postoperative 1-,3-and 5-year OS rates of HCC patients in the negative HBsAg expression group were significantly higher than those of HCC patients in the positive HBsAg expression group (100%, 89.1%, 80.4% and 100%, 75.5%, 58.5%, P=0.008).
CONCLUSIONS
The prognosis of patients with hepatocellular carcinoma with negative HBsAg expression was better than that with positive HBsAg expression. Accordingly, the expression of the liver HBsAg before combined therapy was a prognostic indicator for OS and RFS. For patients with liver HBsAg positive, follow-up should be strengthened and corresponding intervention measures should be taken to improve prognosis.
背景
本研究旨在探讨接受经动脉化疗栓塞联合局部消融治疗的肝细胞癌患者病理标志物与预后之间的关联。
方法
本回顾性研究纳入了111例乙型肝炎病毒（HBV）相关的肝细胞癌（HCC）患者。所有患者均接受了经动脉化疗栓塞（TACE）联合局部消融治疗，并于2013年1月1日至2016年12月31日在首都医科大学附属北京佑安医院治疗前接受了粗针活检。收集了人口统计学、病理指标和临床实验室数据。采用Kaplan-Meier法和Log-rank检验计算并比较累积无复发生存期（RFS）和总生存期（OS），并使用Cox比例风险模型筛选HCC患者复发和长期预后的独立预测因素。
结果
肝组织中HBsAg表达与HCC患者的预后存在相关性。HBsAg表达阴性的患者1年、3年和5年RFS率高于HBsAg表达阳性的患者（分别为78.3%、43.5%、30.4%和58.5%、24.5%、17.0%，P=0.018）。同时，HBsAg表达阴性组HCC患者术后1年、3年和5年OS率显著高于HBsAg表达阳性组HCC患者（分别为100%、89.1%、80.4%和100%、75.5%、58.5%，P=0.008）。
结论
HBsAg表达阴性的肝细胞癌患者预后优于HBsAg表达阳性的患者。因此，联合治疗前肝脏HBsAg的表达是OS和RFS的预后指标。对于肝脏HBsAg阳性的患者，应加强随访并采取相应的干预措施以改善预后。
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