ABSTRACT
Objective:To study the effects of hepatitis B virus DNA mutation at 1762/1764 in the basic core promoter (BCP) on metastasis or recurrence of hepatocellular carcinoma (HCC) after hepalobectomy.Methods:Two-hundred and eleven patients with HCC were included in this study after hepalobectomy.Initial demographic data,clinical history,physical examination,biochemical tests,imaging examination and serum HBV DNA level was recorded.The DNA sequences of the S region and BCP region of HBV was determined by direct sequencing following nested-PCR amplification.Prognostic factors were assessed using a univariate Kaplan-Meier analysis and a multivariate Cox proportional hazards model.Results:Of the 187 HCC cases,119 experienced tumor metastasis or recurrence.The univariate analysis showed that a higher metastasis or recurrence rate was associated with larger tumor size,no intact capsule,positive portal vein tumor thrombosis,higher level of gamma-glutamyl transpeptidase,higher level of HBV DNA and positive BCP mutation.The median metastasis or recurrence time for patients with positive BCP mutation was 9 months (95％ CI:7.922-10.078).Cox analysis indicated that larger tumor size,no intact capsule and positive BCP 1762/1764 double mutations were indepent risk factors for HCC recurrence or metastasis [OR (95％ CI),P:25.946 (2.819-57.149),0.007;8.741 (1.896-21.218),0.033 and 27.966 (8.167-58.132),0.003,repsectively].Conculsion:Infection with HBV carrying the positive BCP 1762/1764 double mutation,initial larger tumor volume as well as no intact capsule around the tumor independently predict the development of HCC metastasis or recurrence and ealier time for metastasis or recurrence after hepalobectomy.
ABSTRACT
Objective:To study the effects of hepatitis B virus DNA mutation at 1762/1764 in the basic core promoter (BCP) on metastasis or recurrence of hepatocellular carcinoma (HCC) after hepalobectomy.Methods:Two-hundred and eleven patients with HCC were included in this study after hepalobectomy.Initial demographic data,clinical history,physical examination,biochemical tests,imaging examination and serum HBV DNA level was recorded.The DNA sequences of the S region and BCP region of HBV was determined by direct sequencing following nested-PCR amplification.Prognostic factors were assessed using a univariate Kaplan-Meier analysis and a multivariate Cox proportional hazards model.Results:Of the 187 HCC cases,119 experienced tumor metastasis or recurrence.The univariate analysis showed that a higher metastasis or recurrence rate was associated with larger tumor size,no intact capsule,positive portal vein tumor thrombosis,higher level of gamma-glutamyl transpeptidase,higher level of HBV DNA and positive BCP mutation.The median metastasis or recurrence time for patients with positive BCP mutation was 9 months (95％ CI:7.922-10.078).Cox analysis indicated that larger tumor size,no intact capsule and positive BCP 1762/1764 double mutations were indepent risk factors for HCC recurrence or metastasis [OR (95％ CI),P:25.946 (2.819-57.149),0.007;8.741 (1.896-21.218),0.033 and 27.966 (8.167-58.132),0.003,repsectively].Conculsion:Infection with HBV carrying the positive BCP 1762/1764 double mutation,initial larger tumor volume as well as no intact capsule around the tumor independently predict the development of HCC metastasis or recurrence and ealier time for metastasis or recurrence after hepalobectomy.