科研之友
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摘要
Background: Patients with hepatocellular carcinoma have the risk of postoperative hepatitis B virus (HBV) reactivation (PHR). Antiviral therapy was given to patients with detectable HBV DNA levels but not to patients with undetectable HBV DNA levels. @@@ Methods: In this retrospective study, 258 patients were enrolled (HBV DNA levels <500 copies/mL group, n = 159, and HBV DNA levels >500 copies/mL group, n=99). @@@ Results: A total of 50 patients (19.4%) had PHR. The following significant factors related to PHR were found: without antiviral therapy (hazard ratio [HR] =0.17, 95% confidence interval [CI] 0.031-0.911), hepatitis B e antigen positivity (HR=5.20, 95% CI 1.931-14.007), hepatitis B core antigen S1 positivity (HR=2.54, 95% CI 1.116-5.762), preoperative HBV DNA levels >= 500 copies/mL (HR = 1.28, 95% CI 1.085-2.884), hepatic inflow occlusion (HR=3.60, 95% CI 1.402-9.277), moderate liver cirrhosis or more (HR=2.26, 95% CI 1.001-5.121), and blood transfusion (HR=2.89, 95% CI 0.836-10.041). Recurrence-free survival time was significantly shorter in patients with PHR (23.06 +/- 2.46 months) than in patients without PHR (29.30 +/- 1.27 months). @@@ Conclusion: Antiviral therapy could efficiently decrease the incidence of PHR. Patients with HBV DNA levels <500 copies/mL still have the risk of PHR. PHR remained as a prognostic risk factor for hepatocellular carcinoma recurrence and recurrence-free survival.
