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.
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.
Sun
Hui-Chuan
HC
Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai 200032, China. sunhc@zshospital.com
Zhang
Wei
W
Qin
Lun-Xiu
LX
Zhang
Bo-Heng
BH
Ye
Qing-Hai
QH
Wang
Lu
L
Ren
Ning
N
Zhuang
Peng-Yuan
PY
Zhu
Xiao-Dong
XD
Fan
Jia
J
Tang
Zhao-You
ZY
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
D015415:Biomarkers; D006513:Hepatitis B e Antigens