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Baseline HBV-DNA load plus AST/ALT ratio predicts prognosis of HBV-related hepatocellular carcinoma after hepatectomy: A multicentre study.

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机构: [1]Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, China [2]Laboratory of Liver Transplantation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital of Sichuan University, Chengdu, China [3]Institute of Clinical Pathology, West China Hospital of Sichuan University, Chengdu, China [4]Department of Hepatobiliary Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences, Chengdu, China [5]Department of Hepatobiliary and Pancreatic Surgery, The First People’s Hospital of Neijiang City, Neijiang, China [6]Department of Hepatobiliary and Pancreatic Surgery, The Second People’s Hospital of Yibin, Yibin, China
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关键词: AST/ALT ratio HBV-DNA hepatectomy hepatocellular carcinoma prognosis

摘要:
Hepatitis B viral (HBV) load and hepatic enzymes play a critical role in hepatocellular carcinoma (HCC) development. However, the clinical significance of these in HBV-related HCC patients after hepatectomy remains unclear. In this study, we analysed 1,940 HBV-related HCC patients who underwent hepatectomy from four hospitals in west China. Risk classification was constructed based on baseline HBV-DNA load and AST/ALT ratio. Based on the HBV-DNA load and AST/ALT ratio classification, four types with distinguishable prognoses were established. Type 1 patients had the best prognosis with 5-year overall survival (OS) of 69.8%, followed by type 2 and type 3 patients, whereas type 4 patients had the worst prognosis with 5-year OS of 42.7%. Similarly, the four types had statistically different recurrence-free survival. This classification was significantly associated with HCC recurrence (hazard ratio [HR]:1.492, p < .001) and long-term survival (HR: 1.574, p = .001). Pathologically, type 4 correlated with more advanced tumours considering tumour size and microvascular invasion than those in type 1, 2, or 3. Moreover, type 4 patients had more severe hepatic inflammation in underlying liver. Conversely, type 1 patients had an active tumour immune microenvironment as indicated by more CD8+ T cell infiltration and less PD-L1 expression. In conclusion, the classfication based on baseline HBV-DNA load and AST/ALT ratio could effectively stratify HBV-related HCC patients with distinguishable prognoses after hepatectomy.© 2021 John Wiley & Sons Ltd.

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出版当年[2021]版:
大类 | 2 区 医学
小类 | 2 区 病毒学 3 区 胃肠肝病学 3 区 传染病学
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 传染病学 3 区 病毒学 4 区 胃肠肝病学
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出版当年[2021]版:
Q3 GASTROENTEROLOGY & HEPATOLOGY Q3 INFECTIOUS DISEASES Q3 VIROLOGY
最新[2023]版:
Q2 GASTROENTEROLOGY & HEPATOLOGY Q3 INFECTIOUS DISEASES Q3 VIROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

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第一作者机构: [1]Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, China [2]Laboratory of Liver Transplantation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital of Sichuan University, Chengdu, China [3]Institute of Clinical Pathology, West China Hospital of Sichuan University, Chengdu, China
通讯作者:
通讯机构: [1]Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, China [2]Laboratory of Liver Transplantation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital of Sichuan University, Chengdu, China [*1]West China Hospital of Sichuan University, 610041 Chengdu, Sichuan Province, China
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