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Perioperative antiviral therapy improves the prognosis of HBV DNA-negative patients with HBV-related hepatocellular carcinoma.

围手术期抗病毒治疗可改善 HBV DNA 阴性的 HBV 相关肝细胞癌患者的预后。

  • 影响因子:2.54
  • DOI:10.1080/17474124.2020.1784727
  • 作者列表:"Li C","Li ZC","Ma L","Li LQ","Zhong JH","Xiang BD","Gong WF
  • 发表时间:2020-06-18
Abstract

OBJECTIVE:To investigate the effect of perioperative antiviral therapy on the prognosis of hepatitis B virus (HBV) DNA-negative patients with HBV-related hepatocellular carcinoma (HCC). METHODS:The clinical data of 140 patients who were positive for hepatitis B surface antigen (HBsAg) but negative for HBV DNA before partial hepatectomy were retrospectively analyzed. Patients who received perioperaive antiviral therapy were divided into the antiviral therapy group, and those who did not receive any antiviral therapies were divided into the non-antiviral therapy group. Propensity score matching (PSM) was used to match patients 1:1 to eliminate the influence of confounding factors on prognosis. Postoperative liver function, HBV reactivation rate, recurrence-free survival (RFS) and overall survival (OS) were compared between the two groups. After excluding patients with HBV reactivation, the prognostic analysis of the samples was conducted again, and then to observe whether perioperative antiviral therapy was effective for these patients who did not have HBV reactivation after partial hepatectomy. RESULTS:A total of 140 patients were included in this study, including 60 in the antiviral therapy group and 80 in the non-antiviral therapy group. Compared with the non-antiviral therapy group, the antiviral therapy group had a lower rate of HBV reactivation and better postoperative liver function (P < 0.05). The 1-year, 2-year and 3-year survival rates of the antiviral therapy group were better than those of the non-antiviral therapy group before or after PSM (P < 0.05). Prognostic analysis excluding 11 patients with HBV reactivation showed that perioperative antiviral therapy could significantly improve OS (P = 0.004), but had no significant effect on RFS (P = 0.056). Multivariate analyses showed that microvascular invasion (MVI) was the only independent risk factor for tumor recurrence, and antiviral therapy was associated with OS. CONCLUSION:Perioperative antiviral therapy can significantly reduce the risk of HBV reactivation and improve postoperative liver function, and also significantly improve RFS and OS.

摘要

目的: 探讨围手术期抗病毒治疗对乙型肝炎病毒 (HBV) DNA 阴性的 HBV 相关性肝细胞癌 (HCC) 患者预后的影响。 方法: 回顾性分析 140 例肝部分切除术前乙肝表面抗原 (HBsAg) 阳性但 HBV DNA 阴性患者的临床资料。将接受围手术期抗病毒治疗的患者分为抗病毒治疗组,未接受任何抗病毒治疗的患者分为非抗病毒治疗组。采用倾向评分匹配 (PSM) 1:1 匹配患者,消除混杂因素对预后的影响。比较两组患者术后肝功能、 HBV 再激动率、无复发生存率 (RFS) 和总生存率 (OS)。排除 HBV 再激活患者后,再次对样本进行预后分析,然后观察围手术期抗病毒治疗对这些肝部分切除术后未发生 HBV 再激活的患者是否有效。 结果: 本研究共纳入 140 例患者,其中抗病毒治疗组 60 例,非抗病毒治疗组 80 例。与未抗病毒治疗组比较,抗病毒治疗组 HBV 再激动率较低,术后肝功能较好 (P <0.05)。PSM 前后抗病毒治疗组 1 、 2 、 3 年生存率均优于非抗病毒治疗组 (P <0.05)。排除 11 例 HBV 再激活患者的预后分析显示,围手术期抗病毒治疗可显著改善 OS (P = 0.004),但对 RFS 无显著影响 (P = 0.056)。多因素分析显示微血管侵犯 (MVI) 是肿瘤复发的唯一独立危险因素,抗病毒治疗与 OS 相关。 结论: 围手术期抗病毒治疗可显著降低 HBV 再激活风险,改善术后肝功能,同时也显著改善 RFS 和 OS。

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作者列表:["Moon AM","Jiang Y","Rogal SS","Tapper EB","Lieber SR","Barritt AS 4th"]

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翻译标题与摘要 下载文献
影响因子:3.87
发表时间:2020-02-01
DOI:10.1111/liv.14321
作者列表:["Chen VL","Chen Y","Du X","Handelman SK","Speliotes EK"]

METHODS:BACKGROUND AND AIMS:Cirrhosis is characterized by extensive fibrosis of the liver and is a major cause of liver-related mortality. Cirrhosis is partially heritable but genetic contributions to cirrhosis have not been systemically explored. Here, we carry out association analyses with cirrhosis in two large biobanks and determine the effects of cirrhosis associated variants on multiple human disease/traits. METHODS:We carried out a genome-wide association analysis of cirrhosis as a diagnosis in UK BioBank (UKBB; 1088 cases vs. 407 873 controls) and then tested top-associating loci for replication with cirrhosis in a hospital-based cohort from the Michigan Genomics Initiative (MGI; 875 cases of cirrhosis vs. 30 346 controls). For replicating variants or variants previously associated with cirrhosis that also affected cirrhosis in UKBB or MGI, we determined single nucleotide polymorphism effects on all other diagnoses in UKBB (PheWAS), common metabolic traits/diseases and serum/plasma metabolites. RESULTS:Unbiased genome-wide association study identified variants in/near PNPLA3 and HFE, and candidate variant analysis identified variants in/near TM6SF2, MBOAT7, SERPINA1, HSD17B13, STAT4 and IFNL4 that reproducibly affected cirrhosis. Most affected liver enzyme concentrations and/or aspartate transaminase-to-platelet ratio index. PheWAS, metabolic trait and serum/plasma metabolite association analyses revealed effects of these variants on lipid, inflammatory and other processes including new effects on many human diseases and traits. CONCLUSIONS:We identified eight loci that reproducibly associate with population-based cirrhosis and define their diverse effects on human diseases and traits.

翻译标题与摘要 下载文献
影响因子:2.57
发表时间:2020-02-01
DOI:10.1111/eci.13198
作者列表:["Li H","Wieser A","Zhang J","Liss I","Markwardt D","Hornung R","Neumann-Cip AC","Mayerle J","Gerbes A","Steib CJ"]

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