J Hepatol:接受肝切除术后抗病毒治疗能够提高存在HBV感染的胆管细胞癌患者的生存率

2017-11-25 MedSci MedSci原创

有潜在HBV感染的ICC患者,发生病毒再激活后,患者临床预后较差,AVT降低了病毒的再活化,延长了高病毒载量患者的长期生存率。

研究背景:本研究的目的是检验抗病毒治疗(AVT)对因肝内胆管细胞癌(ICC)而进行肝切除术(LR)患者(存在潜在乙型肝炎病毒感染)生存率的影响。

研究方法:对2006-2011年间在两家医疗中心接受LR手术的928例存在HBV感染的ICC患者的数据进行了分析。此研究获得了病毒再活化、肿瘤复发、癌特异性生存(CSS)和总体生存率(OS)的数据。通过调整潜在协变量,采用时间相关Cox回归模型对生存率进行了分析。

研究结果:术前接受AVT患者,术前未接受AVT、低病毒载量的患者(< 2000IU/mL),术前未接受AVT、高病毒载量的患者(≥2000IU/mL),术后病毒复发的比率分别是3.3%、8.3%、15.7%(P <0.001)。高病毒载量和病毒再活化是复发的独立危险因素(危险比率[HR]:1.22和1.34),CSS(HR:1.36和1.46)和OS(HR:1.23和1.36)。接受AVT的患者的5年复发率,CSS和OS等指标显著优于未接受AVT和高病毒载量的患者(86.5%, 20.9% and 20.5%, all P <0.001);接受AVT患者的5年复发率,CSS和OS等指标与未接受AVT、病毒载量较低的患者差异最小(71.7%, 35.5% 和 33.5%, P =0.057, 0.051和0.060)。

与高病毒载量的无AVT患者相比,在术前或术后进行AVT的患者有较好的长期预后(再复发HR:0.44和0.54 ;CSS HR 0.38和0.57;OS HR 0.46和0.54)。

研究结论:有潜在HBV感染的ICC患者,发生病毒再激活后,患者临床预后较差,AVT降低了病毒的再活化,延长了高病毒载量患者的长期生存率。

原始出处:


Lei Z, Xia Y, Si A, et al. Antiviral Therapy Improves Survival in patients with HBV infection and Intrahepatic Cholangiocarcinoma undergoing Liver Resection. J Hepatol, 2017, Nov 16. pii: S0168-8278(17)32438-8. doi: 10.1016/j.jhep.2017.11.015.

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    2018-01-26 changfy
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    2018-04-03 klivis
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  5. 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  6. 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  7. 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  8. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292394, encodeId=20bc12923949d, content=<a href='/topic/show?id=a3b4554e19d' target=_blank style='color:#2F92EE;'>#抗病毒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55471, encryptionId=a3b4554e19d, topicName=抗病毒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=52c7237, createdName=yahu, createdTime=Mon Nov 27 03:10:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1292826, encodeId=490b1292826fb, content=<a href='/topic/show?id=9d23554e95a' target=_blank style='color:#2F92EE;'>#抗病毒治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55479, encryptionId=9d23554e95a, topicName=抗病毒治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Mon Nov 27 03:10:00 CST 2017, time=2017-11-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1417881, encodeId=d4d0141e881cd, content=<a href='/topic/show?id=bcb081181dc' target=_blank style='color:#2F92EE;'>#肝切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81181, encryptionId=bcb081181dc, topicName=肝切除术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1bcb3304824, createdName=zexyw02, createdTime=Mon Nov 27 03:10:00 CST 2017, time=2017-11-27, status=1, ipAttribution=)]
    2017-11-27 yahu
  9. 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