The influence of hepatitis B DNA level and antiviral therapy on recurrence after initial curative treatment in patients with hepatocellular carcinoma

被引:152
作者
Chuma, Makoto [1 ]
Hige, Shuhei [1 ]
Kamiyama, Toshiya [2 ]
Meguro, Takashi [3 ]
Nagasaka, Atsushi [4 ]
Nakanishi, Kazuaki [2 ]
Yamamoto, Yoshiya [5 ]
Nakanishi, Mitsuru [1 ]
Kohara, Toshihisa [1 ]
Sho, Takuya [1 ]
Yamamoto, Keiko [1 ]
Horimoto, Hiromasa [1 ]
Kobayashi, Tomoe [1 ]
Yokoo, Hideki [2 ]
Matsushita, Michiaki [2 ]
Todo, Satoru [2 ]
Asaka, Masahiro [1 ]
机构
[1] Hokkaido Univ, Dept Gastroenterol & Hematol, Kita Ku, Sapporo, Hokkaido 0608638, Japan
[2] Hokkaido Univ, Dept Gen Surg, Sapporo, Hokkaido 0608638, Japan
[3] Hokkaido Gastroenterol Hosp, Dept Internal Med, Sapporo, Hokkaido, Japan
[4] Sapporo Municipal Hosp, Dept Gastroenterol, Sapporo, Hokkaido, Japan
[5] Hakodate Municipal Hosp, Dept Gastroenterol, Hakodate, Hokkaido, Japan
关键词
Hepatocellular carcinoma; Hepatitis B virus; Recurrence; Antiviral therapy; RISK-FACTORS; INTRAHEPATIC RECURRENCE; RADIOFREQUENCY ABLATION; VIRAL LOAD; LAMIVUDINE; VIRUS; RESECTION; PROGNOSIS; EFFICACY; ANTIGEN;
D O I
10.1007/s00535-009-0093-z
中图分类号
R57 [消化系及腹部疾病];
学科分类号
100201 [内科学];
摘要
Prediction and prevention of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) recurrence is an important clinical issue. We investigated whether HBV DNA level and antiviral therapy are associated with HCC recurrence. This retrospective study involved 103 patients who underwent hepatic resection or radiofrequency ablation for initial HCC. Patients were divided into four groups. Thirty had high serum HBV DNA levels (> 4 log(10) copies/mL) and had not received antiviral therapy (high virus group; HVG). Thirty-four had low HBV DNA levels (a parts per thousand currency sign4 log(10) copies/mL) and had not received antiviral therapy (low virus group; LVG). Twenty received antiviral therapy after HCC developed (therapeutic group A, TG-A). Nineteen received antiviral therapy before HCC developed (therapeutic group B, TG-B). Cumulative HCC recurrence rates at 3 years in the HVG, LVG, TG-B, and TG-A were 71.1%, 42.2%, 42.3%, and 52.0%, respectively. Recurrence rates differed significantly between the HVG and LVG (P = 0.016) and between the HVG and TG-B (P = 0.008). Recurrence rate in the TG-A was marginally lower than in the HVG (P = 0.10). On multivariate analysis, high serum hepatitis B virus DNA levels (hazard ratio: HR 2.67; 95% CI 1.31-5.47; P = 0.007) and absence of antiviral therapy (HR 2.57; 95% CI 1.34-4.94; P = 0.005) were independent risk factors for hepatocellular carcinoma recurrence. HBV DNA level and antiviral therapy are associated with HCC recurrence. For patients with high HBV DNA levels, antiviral therapy before the development of HCC is important for prevention of recurrence.
引用
收藏
页码:991 / 999
页数:9
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