Xu Wei, Gong Huai, Li Bolun, Yin Xinmin
Department of Hepatobiliary Surgery, The First Hospital Affiliated with Hunan Normal University, Hunan Provincial People's Hospital, No. 61 West Jiefang Road, Changsha 410005, China.
Department of Hepatobiliary Surgery, The First Hospital Affiliated with Hunan Normal University, Hunan Provincial People's Hospital, Changsha, China.
Ther Adv Med Oncol. 2024 Oct 18;16:17588359241289202. doi: 10.1177/17588359241289202. eCollection 2024.
To explore clinical features and prognosis of hepatocellular carcinoma (HCC) in hepatitis B virus surface antigen (HBsAg)-serocleared patients and identify risk factors associated with postoperative recurrence after curative hepatectomy.
Patients who had undergone initial hepatectomy for HCC from January 2010 through December 2022. Clinicopathological data were compared between HBsAg-seropositive and HBsAg-serocleared patients. Furthermore, risk factors associated with early and late postoperative HCC recurrence (early and late recurrences (ER and LR), respectively) were analyzed for HBsAg-serocleared HCC patients treated by curative hepatectomy.
A total of 2184 consecutive patients undergoing initial hepatectomy for HCC were enrolled, including 339 (15.5%) HBsAg-serocleared and 1845 (84.5%) HBsAg-seropositive cases. Tumor characteristics were comparable between the two groups. After curative hepatectomy, the ER rate was lower in the HBsAg-serocleared group than in the HBsAg-seropositive group (16.2% vs 26.3%; = 0.000). LR rates in the HBsAg-seropositive and HBsAg-serocleared groups were similar (8.3% vs 6.9%, respectively, = 0.418). Multivariate analysis showed that among HBsAg-serocleared patients, Hong Kong Liver Cancer stage and microvascular invasion were risk factors associated with postoperative ER, while γ-glutamyl transferase level and neutrophil-to-lymphocyte ratio were associated with LR.
HBsAg-serocleared and HBsAg-seropositive HCC patients exhibited similar tumor characteristics. Curative hepatectomy-treated HBsAg-serocleared HCC patients experienced a lower ER rate and better short-term (⩽3 years) overall survival (OS) rates than their HBsAg-seropositive counterparts. LR, very late recurrence, and long-term (4-, and 5-year) OS rates were similar between the two groups.
探讨乙肝表面抗原（HBsAg）血清学清除患者肝细胞癌（HCC）的临床特征和预后，并确定根治性肝切除术后与术后复发相关的危险因素。
选取2010年1月至2022年12月期间因HCC首次接受肝切除术的患者。比较HBsAg血清学阳性和HBsAg血清学清除患者的临床病理数据。此外，对接受根治性肝切除术治疗的HBsAg血清学清除的HCC患者分析与术后早期和晚期HCC复发（分别为早期和晚期复发（ER和LR））相关的危险因素。
共纳入2184例因HCC首次接受肝切除术的连续患者，其中339例（15.5%）为HBsAg血清学清除患者，1845例（84.5%）为HBsAg血清学阳性患者。两组的肿瘤特征具有可比性。根治性肝切除术后，HBsAg血清学清除组的ER率低于HBsAg血清学阳性组（16.2%对26.3%；P = 0.000）。HBsAg血清学阳性组和HBsAg血清学清除组的LR率相似（分别为8.3%和6.9%，P = 0.418）。多因素分析显示，在HBsAg血清学清除的患者中，香港肝癌分期和微血管侵犯是与术后ER相关的危险因素，而γ-谷氨酰转移酶水平和中性粒细胞与淋巴细胞比值与LR相关。
HBsAg血清学清除和HBsAg血清学阳性的HCC患者表现出相似的肿瘤特征。与HBsAg血清学阳性的患者相比，接受根治性肝切除术治疗的HBsAg血清学清除的HCC患者的ER率较低，短期（≤3年）总生存率（OS）较好。两组之间的LR、极晚期复发和长期（4年和5年）OS率相似。
