title: Effect of the presence of hepatitis B e antigen on prognosis after liver resection for hepatocellular carcinoma in patients with chronic hepatitis B.
abstract: We examineded the clinical effects of serum hepatitis B e antigen (HBeAg) positivity on clinicopathologic findings and prognosis after liver resection for hepatocellular carcinoma (HCC) in patients with chronic hepatitis B. A series of 56 patients who underwent curative resection were divided into two groups: 25 HBeAg-positive patients (group 1) and 31 HBeAg-negative patients (group 2). The mean age was significantly lower in group 1 than in group 2 (p = 0.0021), and the proportion of patients with symptoms was significantly higher in group 1 than in group 2 (p = 0.037). There were no significant differences in other clinical findings between the two groups, including laboratory test results, coexisting medical conditions, and operative methods. Although tumor size, degree of differentiation of the main tumor, and the prevalence of vascular invasion did not differ between the groups, the prevalence of intrahepatic metastasis and the proportion of patients with active hepatitis were significantly higher in group 1 than in group 2 (p = 0.009 and p = 0.043, respectively). Tumor-free and cumulative survival rates were significantly lower in group 1 than in group 2 (p = 0.022 and p = 0.0001, respectively). Multivariate analysis of various possible risk factors demonstrated serum HBeAg positivity to be an independent risk factor for recurrence [risk ratio (RR) 2.49; 95% confidence interval (CI) 1.12-5.49; p = 0.032] and an independent unfavorable factor for the survival time (RR 7.58; 95% CI 2.10-27.8; p = 0.0020). We concluded that the prognosis after liver resection for HCC is worse for HBeAg-positive patients than for HBeAg-negative patients.
authors.affiliation: Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan. m7696493@msic.med.osaka-cu.jp
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hirohashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamazaki
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Matsuyama
authors.forename: Hiromu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Horii
authors.forename: Taichi
authors.initials: T
authors.lastname: Shuto
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kawai
authors.forename: Kenichi
authors.initials: K
authors.lastname: Wakasa
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nishiguchi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000276:immunology / Q000601:surgery*; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000276:immunology; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000276:immunology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate
chemical_list: D006513:Hepatitis B e Antigens