title: Impact of occult hepatitis B virus infection on outcome after resection for non-B non-C hepatocellular carcinoma.
abstract: BACKGROUND
  To investigate the clinicopathologic characteristics of patients with both hepatitis B virus-surface antigen and hepatitis C virus antibody negative hepatocellular carcinoma (non-B non-C HCC [NBNC-HCC]) and examine the impact of occult hepatitis B virus infection (OBI) on patients' survival.
  
  
  METHODS
  All patients with OBI were identified from a database of patients with NBNC-HCC who underwent surgical resection between January 1, 2006, and December 31, 2008. Their clinicopathologic and survival characteristics were compared with NBNC-HCC patients without OBI.
  
  
  RESULTS
  Out of the 86 NBNC-HCC patients, 59 patients (68.6%) with OBI. A higher prevalence of hepatitis B core antigen positive rate, low platelet count, portal hypertension, and liver cirrhosis were observed in NBNC-HCC patients with OBI. The 1- and 3-y recurrence free survival rates were 66% and 25% in OBI group and 89% and 70% in the no OBI group, respectively (P < 0.001). The 1-, 3-, and 5-y overall survival rates were 86%, 55%, and 51% in OBI group and 93%, 85%, and 66% in no OBI group, respectively (P = 0.112). Multivariate analysis revealed that OBI (hazard ratio [HR] = 2.122; 95% confidence interval [CI], 1.086-4.149; P = 0.028), liver cirrhosis (HR = 2.411; 95% CI, 1.337-4.345; P = 0.003), and vascular invasion (HR = 5.858; 95% CI, 2.799-12.261; P < 0.001) were independent poor prognostic factors for recurrence free survival of patients with NBNC-HCC.
  
  
  CONCLUSIONS
  NBNC-HCC patients with OBI had a poorer prognosis. OBI can be a useful predictor for recurrence in patients with NBNC-HCC after surgery.
authors.affiliation: Department of Surgical Oncology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Zhen-Feng
authors.initials: ZF
authors.lastname: Wu
authors.affiliation: Department of Surgical Oncology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Surgical Oncology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China. Electronic address: weisu00@126.com.
authors.forename: Wei-Su
authors.initials: WS
authors.lastname: Li
authors.affiliation: Fifth Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China. Electronic address: lacent1981@163.com.
authors.forename: Hai-Bin
authors.initials: HB
authors.lastname: Zhang
authors.affiliation: Fifth Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Yang
authors.affiliation: Department of Surgical Oncology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Xue-Quan
authors.initials: XQ
authors.lastname: Yao
authors.affiliation: Department of Surgical Oncology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Fu-Kun
authors.initials: FK
authors.lastname: Liu
authors.affiliation: Fifth Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Guang-Shun
authors.initials: GS
authors.lastname: Yang
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery / Q000821:virology; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000401:mortality*; D006510:Hepatitis B Antibodies / Q000097:blood; D006512:Hepatitis B Core Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000401:mortality* / Q000601:surgery*; D018937:Hepatitis C Antibodies / Q000097:blood; D018936:Hepatitis C Antigens / Q000097:blood; D019698:Hepatitis C, Chronic / Q000401:mortality / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery / Q000821:virology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D016019:Survival Analysis
chemical_list: D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D018937:Hepatitis C Antibodies; D018936:Hepatitis C Antigens
keywords: Non-B non-C hepatocellular carcinoma; Occult hepatitis B virus infection; Prognostic factor; Surgery