Is chronic hepatitis B infection a protective factor for the progression of advanced pancreatic ductal adenocarcinoma? An analysis from a large multicenter cohort study.
OBJECTIVE
Whether the progression of advanced pancreatic ductal adenocarcinoma (PDAC) patients could be affected by HBV exposure remains to be determined. Therefore, we conducted this study to assess the effect of HBV infection on PDAC progression among a large cohort in China.


METHODS
A multicenter cohort study was conducted to explore whether liver metastasis and overall survival in locally advanced and metastatic PDAC could be affected by HBV infection. In this study, we collected 1,526 advanced PDAC patients at three participating hospitals - Shanghai Cancer Center, Changhai Hospital and Ruijin Hospital from 2004 to 2013. The association between HBV status and advanced PDAC progression was then examined.


RESULTS
In multivariable Logistic regression model, chronic hepatitis B(CHB) infection was inversely associated with synchronous liver metastasis compared to non HBV infection (OR 0.41, 95% CI 0.19-0.85) for stage IV patients. In a multivariable Cox model, CHB infection (HR=0.11, 95% CI 0.02-0.82) is considered as a protective factor of metachronous liver metastasis compared to Non HBV infection for stage III patients. For stage IV patients, CHB infection was inversely associated with overall survival compared to non HBV infection (HR 0.70, 95% CI 0.51-0.95). Inactive carrier(IC) and resolved HBV infection showed no significant association with survival compared to non HBV infection.


CONCLUSIONS
This study indicated that CHB infection may serve as an independent factor which decrease synchronous or metachronous liver metastasis, and increase overall survival among advanced PDAC patients.
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.|Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
Qiwen
Q
Chen
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Zhouyu
Z
Ning
Digestive Endoscopy Center, Department of Gastroenterology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China.
Lei
L
Wang
Department of Integrative Medicine of Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Haifeng
H
Ying
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Shu
S
Dong
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Chenyue
C
Zhang
Department of Integrative Medicine of Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Xiaoheng
X
Shen
Department of Integrative Medicine of Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yuanbiao
Y
Guo
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Hao
H
Chen
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Xiaoyan
X
Zhu
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Yehua
Y
Shen
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Weidong
W
Shi
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Yongqiang
Y
Hua
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Kun
K
Wang
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Junhua
J
Lin
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Litao
L
Xu
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Lianyu
L
Chen
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Lanyun
L
Feng
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Xiumei
X
Zhang
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Jing
J
Xie
Department of Endoscopy and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Bo
B
Sun
Department of Radiology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Yaqin
Y
Sun
Department of Radiology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Wenchao
W
Gu
Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
Mei
M
Kang
Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
Zheng
Z
Tang
Department of Clinical Laboratory and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Zhujun
Z
Chen
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Zhen
Z
Chen
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Luming
L
Liu
Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
Jinming
J
Yu
Digestive Endoscopy Center, Department of Gastroenterology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China.
Zhaoshen
Z
Li
Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China.
Zhiqiang
Z
Meng
D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000556:secondary; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
HBV; pancreatic adenocarcinoma