title: High HBV-DNA titer in surrounding liver rather than in hepatocellular carcinoma tissue predisposes to recurrence after curative surgical resection.
abstract: OBJECTIVE
  In this study the authors intended to investigate the relationship between intrahepatic hepatitis B virus (HBV)-DNA concentrations and posthepatectomy recurrence of HBV-associated hepatocellular carcinoma (HCC).
  
  
  BACKGROUND
  High HBV-DNA level is strongly associated with HCC development in chronic HBV infection and considered to be a risk factor of HCC recurrence.
  
  
  METHODS
  A total of 109 patients with HBV-associated HCC who underwent curative surgical resection were followed up every 3 to 6 months for a median of 82 months. Intrahepatic total HBV-DNA titer was measured in HCC and surrounding liver tissues using a TaqMan probe-based real-time polymerase chain reaction method. HBV-DNA titers in HCC and surrounding liver were compared in accordance with patients' clinical, radiologic, and histopathological characteristics. The relationships between HBV-DNA titers in HCC or surrounding liver tissues and cumulative HCC recurrence rates were determined.
  
  
  RESULTS
  Of the 109 patients, 67 (62%) showed posthepatectomy recurrence of HCC. In all patients, total HBV-DNA titers were significantly higher in HCCs than in surrounding liver tissues (P=0.019). HCC recurred more frequently in patients with higher than those with lower HBV-DNA titers in surrounding liver tissues (P=0.009). In contrast, the HCC recurrence rates were similar in patients with higher and those with lower HBV-DNA titers in HCC specimens (P=0.301). Multivariate analysis showed that tumor size >5 cm (P=0.008), the presence of portal vein thrombus (P=0.001), and high HBV-DNA titer in surrounding liver tissues (P=0.002) were independent risk factors for posthepatectomy HCC recurrence in patients with HBV-associated HCC.
  
  
  CONCLUSIONS
  In patients with HBV-associated HCC, high HBV-DNA titer in surrounding liver rather than in the HCC itself is associated with posthepatectomy HCC recurrence after curative surgical resection.
authors: Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors: Jong Gi
authors: JG
authors: Choi
authors: Young-Hwa
authors: YH
authors: Chung
authors: Jeong A
authors: JA
authors: Kim
authors: Young-Joo
authors: YJ
authors: Jin
authors: Won Hyung
authors: WH
authors: Park
authors: Danbi
authors: D
authors: Lee
authors: Ju Hyun
authors: JH
authors: Shim
authors: Yoon Seon
authors: YS
authors: Lee
authors: Dong Dae
authors: DD
authors: Seo
authors: Myoung Kuk
authors: MK
authors: Jang
authors: Kang Mo
authors: KM
authors: Kim
authors: Young-Suk
authors: YS
authors: Lim
authors: Han Chu
authors: HC
authors: Lee
authors: Yung Sang
authors: YS
authors: Lee
authors: Eunsil
authors: E
authors: Yu
authors: Young Joo
authors: YJ
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006515:Hepatitis B virus / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008099:Liver / Q000601:surgery / Q000821:virology*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D012008:Recurrence; D012307:Risk Factors
chemical_list: D004279:DNA, Viral