Contribution of Hepatitis B Virus Infection to the Aggressiveness of Primary Liver Cancer: A Clinical Epidemiological Study in Eastern China

Background and aims: The contribution of hepatitis B virus (HBV) infection to the aggressiveness of primary liver cancer (PLC) remains controversial. We aimed to characterize this in eastern China.Methods: We enrolled 8,515 PLC patients whose specimens were reserved at the BioBank of the hepatobilia...

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Main Authors: Fan Yang, Longteng Ma, Yuan Yang, Wenbin Liu, Jun Zhao, Xi Chen, Mengchao Wang, Hongwei Zhang, Shuqun Cheng, Feng Shen, Hongyang Wang, Weiping Zhou, Guangwen Cao
Format: Article
Language:English
Published: Frontiers Media S.A. 2019-05-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fonc.2019.00370/full
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author Fan Yang
Longteng Ma
Yuan Yang
Wenbin Liu
Jun Zhao
Xi Chen
Mengchao Wang
Hongwei Zhang
Shuqun Cheng
Feng Shen
Hongyang Wang
Weiping Zhou
Guangwen Cao
author_facet Fan Yang
Longteng Ma
Yuan Yang
Wenbin Liu
Jun Zhao
Xi Chen
Mengchao Wang
Hongwei Zhang
Shuqun Cheng
Feng Shen
Hongyang Wang
Weiping Zhou
Guangwen Cao
author_sort Fan Yang
collection DOAJ
description Background and aims: The contribution of hepatitis B virus (HBV) infection to the aggressiveness of primary liver cancer (PLC) remains controversial. We aimed to characterize this in eastern China.Methods: We enrolled 8,515 PLC patients whose specimens were reserved at the BioBank of the hepatobiliary hospital (Shanghai, China) during 2007–2016. Of those, 3,124 who received primary radical resection were involved in survival analysis. A nomogram was constructed to predict the survivals using preoperative parameters.Results: Hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and combined hepatocellular cholangiocarcinoma (CHC) accounted for 94.6, 3.7, and 1.7%, respectively. The rates of HBV infection were 87.5, 49.2, and 80.6%, respectively. HBV infection was significantly associated with 10-year earlier onset, more cirrhosis, higher α-fetoprotein, higher carbohydrate antigen 19-9 (CA19-9), more microvascular invasion (MVI), lower neutrophil-to-lymphocyte ratio (NLR), and lower platelet-to-lymphocyte ratio (PLR) in HCC. HBV infection was also associated with 7-year earlier onset, more cirrhosis, higher α-fetoprotein, more MVI, and lower PLR in ICC. In the multivariate Cox analysis, high circulating HBV DNA, α-fetoprotein, CA19-9, NLR, tumor size, number, encapsulation, Barcelona Clinic Liver Cancer (BCLC) stage, and MVI predicted an unfavorable prognosis in HCC; only CA19-9 and BCLC stage, rather than HBV-related parameters, had prognostic values in ICC. A nomogram constructed with preoperative HBV-related parameters including HBV load, ultrasonic cirrhosis, and α-fetoprotein perform better than the current staging systems in predicting postoperative survival in HCC.Conclusion: HBV promotes the aggressiveness of HCC in Chinese population. The contributions of HBV to ICC and other etiological factors to HCC might be indirect via arousing non-resolving inflammation.
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spelling doaj.art-f89e57e443004731a9e89f4657bb970d2022-12-22T03:03:27ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2019-05-01910.3389/fonc.2019.00370461438Contribution of Hepatitis B Virus Infection to the Aggressiveness of Primary Liver Cancer: A Clinical Epidemiological Study in Eastern ChinaFan Yang0Longteng Ma1Yuan Yang2Wenbin Liu3Jun Zhao4Xi Chen5Mengchao Wang6Hongwei Zhang7Shuqun Cheng8Feng Shen9Hongyang Wang10Weiping Zhou11Guangwen Cao12Department of Epidemiology, Second Military Medical University, Shanghai, ChinaDepartment of Epidemiology, Second Military Medical University, Shanghai, ChinaEastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Epidemiology, Second Military Medical University, Shanghai, ChinaEastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Epidemiology, Second Military Medical University, Shanghai, ChinaEastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Epidemiology, Second Military Medical University, Shanghai, ChinaEastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, ChinaEastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, ChinaEastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, ChinaEastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, ChinaDepartment of Epidemiology, Second Military Medical University, Shanghai, ChinaBackground and aims: The contribution of hepatitis B virus (HBV) infection to the aggressiveness of primary liver cancer (PLC) remains controversial. We aimed to characterize this in eastern China.Methods: We enrolled 8,515 PLC patients whose specimens were reserved at the BioBank of the hepatobiliary hospital (Shanghai, China) during 2007–2016. Of those, 3,124 who received primary radical resection were involved in survival analysis. A nomogram was constructed to predict the survivals using preoperative parameters.Results: Hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and combined hepatocellular cholangiocarcinoma (CHC) accounted for 94.6, 3.7, and 1.7%, respectively. The rates of HBV infection were 87.5, 49.2, and 80.6%, respectively. HBV infection was significantly associated with 10-year earlier onset, more cirrhosis, higher α-fetoprotein, higher carbohydrate antigen 19-9 (CA19-9), more microvascular invasion (MVI), lower neutrophil-to-lymphocyte ratio (NLR), and lower platelet-to-lymphocyte ratio (PLR) in HCC. HBV infection was also associated with 7-year earlier onset, more cirrhosis, higher α-fetoprotein, more MVI, and lower PLR in ICC. In the multivariate Cox analysis, high circulating HBV DNA, α-fetoprotein, CA19-9, NLR, tumor size, number, encapsulation, Barcelona Clinic Liver Cancer (BCLC) stage, and MVI predicted an unfavorable prognosis in HCC; only CA19-9 and BCLC stage, rather than HBV-related parameters, had prognostic values in ICC. A nomogram constructed with preoperative HBV-related parameters including HBV load, ultrasonic cirrhosis, and α-fetoprotein perform better than the current staging systems in predicting postoperative survival in HCC.Conclusion: HBV promotes the aggressiveness of HCC in Chinese population. The contributions of HBV to ICC and other etiological factors to HCC might be indirect via arousing non-resolving inflammation.https://www.frontiersin.org/article/10.3389/fonc.2019.00370/fullprimary liver cancerhepatitis virusradical resectionprognosisaggressiveness
spellingShingle Fan Yang
Longteng Ma
Yuan Yang
Wenbin Liu
Jun Zhao
Xi Chen
Mengchao Wang
Hongwei Zhang
Shuqun Cheng
Feng Shen
Hongyang Wang
Weiping Zhou
Guangwen Cao
Contribution of Hepatitis B Virus Infection to the Aggressiveness of Primary Liver Cancer: A Clinical Epidemiological Study in Eastern China
Frontiers in Oncology
primary liver cancer
hepatitis virus
radical resection
prognosis
aggressiveness
title Contribution of Hepatitis B Virus Infection to the Aggressiveness of Primary Liver Cancer: A Clinical Epidemiological Study in Eastern China
title_full Contribution of Hepatitis B Virus Infection to the Aggressiveness of Primary Liver Cancer: A Clinical Epidemiological Study in Eastern China
title_fullStr Contribution of Hepatitis B Virus Infection to the Aggressiveness of Primary Liver Cancer: A Clinical Epidemiological Study in Eastern China
title_full_unstemmed Contribution of Hepatitis B Virus Infection to the Aggressiveness of Primary Liver Cancer: A Clinical Epidemiological Study in Eastern China
title_short Contribution of Hepatitis B Virus Infection to the Aggressiveness of Primary Liver Cancer: A Clinical Epidemiological Study in Eastern China
title_sort contribution of hepatitis b virus infection to the aggressiveness of primary liver cancer a clinical epidemiological study in eastern china
topic primary liver cancer
hepatitis virus
radical resection
prognosis
aggressiveness
url https://www.frontiersin.org/article/10.3389/fonc.2019.00370/full
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