Hepatitis B virus is associated with the clinical features and survival rate of patients with intrahepatic cholangiocarcinoma.
OBJECTIVE
The pathogenesis and development of intrahepatic cholangiocarcinoma (ICC) may be triggered by hepatitis B virus (HBV). We conducted this retrospective study to explore the potential association between HBV infection and the clinical features and survival rate of patients with ICC.


METHODS
Patients with ICC who had undergone a curative resection were enrolled and divided into three groups according to the seropositivity of the hepatitis B surface antigen (HBsAg) and the hepatitis B core antibody (anti-HBc). The groups were as follows: group I, HBsAg (+)/anti-HBc (+); group II, HBsAg (-)/anti-HBc (+); group III HBsAg (-)/anti-HBc (-). The symptoms, pathologic findings, and outcome information of all patients were retrospectively reviewed. The patient sera were isolated to detect anti-HCV, HBsAg, and anti-HBc. Surgical specimens were assessed by hematoxylin and eosin (HE) staining. The expression of cytokeratin 7 was evaluated by immunohistochemistry. Finally, the 1-, 3-, and 5-year cumulative survival rates were analyzed.


RESULTS
Ninety-seven patients with ICC were enrolled in group I (n=26); group II, (n=50), and group III (n=21). A total of 26.8% (26/97) patients with ICC were positive for HBsAg. Patients with HBV-associated ICC tended to be younger (P=0.018), have lower CA19-9 levels (P=0.000), a higher alpha fetal protein (AFP) level (P=0.012) and prothrombin time (P=0.030), a higher risk of hepatic cirrhosis (P=0.001), and poor differentiation (P=0.028). The 1-, 3-, and 5-year cumulative survival rates for patients within the three groups were as follows: 27.3%, 0%, and 0% for group I, respectively; 62.5%, 30.0%, and 0% for group II, respectively; and 87.5%, 66.7%, and 50.0% for group III, respectively. The results were significantly different in an overall comparison (P=0.000).


CONCLUSIONS
Patients with HBV-associated ICC showed different clinicopathological features and lower survival rates compared to patients with ICC without HBV infection.
Department of General Surgery, Peking University Third Hospital, No. 49, Hua Yuan North Road, Haidian District, Beijing 100191, China.
Lian-Yuan
LY
Tao
Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Xiao-Dong
XD
He
Department of General Surgery, Peking University Third Hospital, No. 49, Hua Yuan North Road, Haidian District, Beijing 100191, China. Electronic address: xiudianrong123@sina.com.
Dian-Rong
DR
Xiu
D000328:Adult; D000367:Age Factors; D000368:Aged; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood; D001650:Bile Duct Neoplasms / Q000401:mortality*; D002681:China / Q000453:epidemiology; D018281:Cholangiocarcinoma / Q000401:mortality*; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood*; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011517:Prothrombin Time; D012189:Retrospective Studies; D000509:alpha-Fetoproteins / Q000032:analysis
D015295:Antigens, Tumor-Associated, Carbohydrate; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D000509:alpha-Fetoproteins; C578959:carbohydrate antigen 199, human
Clinical features; Hepatitis B virus; Intrahepatic cholangiocarcinoma; Survival rate