title: Positive serum hepatitis B e antigen is associated with higher risk of early recurrence and poorer survival in patients after curative resection of hepatitis B-related hepatocellular carcinoma.
abstract: OBJECTIVE
  To study the impact of hepatitis B e antigen on tumor recurrence and patients' survival after curative resection of hepatocellular carcinoma.
  
  
  METHODS
  Two hundred and three patients with small hepatocellular carcinomas (3cm) who had undergone curative resection were divided into HBeAg-positive group and HBeAg-negative group. Clinicopathological factors and postoperative outcomes were compared between groups, and risk factors for survival and recurrence were studied.
  
  
  RESULTS
  The median follow-up time was 32.9months. Patients with negative HBeAg had higher 5-year overall survival rates (76% vs 53.9%, hazards ratio (HR): 2.363, 95% CI: 1.335-4.181, p=0.002) and 5-year disease-free survival rates (52.9% vs 37.4%, HR: 1.603, 95% CI: 1.00-2.561, p=0.046). There was no significant difference in operative morbidity and tumor factors between the two groups, but younger age, higher serum alanine aminotransferase levels, and more macronodular cirrhosis were found in the HBeAg-positive group. Multivariate analysis revealed that age >50years, HBeAg positivity and macronodular cirrhosis were independent factors for overall survival, and HBeAg positivity and multiple tumor nodules were independent factors for disease-free survival. Positive serum HBeAg was associated with a higher risk of early recurrence (within 1year).
  
  
  CONCLUSIONS
  HBeAg is associated with a higher risk of early recurrence and poorer survival in patients after curative resection of small HCC.
authors.affiliation: Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai 200032, China. sunhc@zshospital.com
authors.forename: Hui-Chuan
authors.initials: HC
authors.lastname: Sun
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Lun-Xiu
authors.initials: LX
authors.lastname: Qin
authors.forename: Bo-Heng
authors.initials: BH
authors.lastname: Zhang
authors.forename: Qing-Hai
authors.initials: QH
authors.lastname: Ye
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.forename: Ning
authors.initials: N
authors.lastname: Ren
authors.forename: Peng-Yuan
authors.initials: PY
authors.lastname: Zhuang
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Zhu
authors.forename: Jia
authors.initials: J
authors.lastname: Fan
authors.forename: Zhao-You
authors.initials: ZY
authors.lastname: Tang
mesh_terms: D001662:Biliary Tract Surgical Procedures / Q000706:statistics & numerical data; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000821:virology*; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006513:Hepatitis B e Antigens / Q000032:analysis / Q000097:blood*; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000503:physiopathology / Q000821:virology; D008113:Liver Neoplasms / Q000097:blood* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D015415:Biomarkers; D006513:Hepatitis B e Antigens