J Viral Hepat. 2021 Aug 31. doi: 10.1111/jvh.13606. Online ahead of print.
ABSTRACT
Hepatitis B viral (HBV) load and hepatic enzymes play a critical role in hepatocellular carcinoma (HCC) development. The clinical significance of both in HBV-related HCC patients after hepatectomy remains unclear. This study analyzed 1940 HBV-related HCC patients who underwent hepatectomy from four hospitals in west China. Risk classification was constructed based on baseline HBV-DNA level and AST/ALT ratio. Based on the HBV-DNA and AST/ALT ratio classification, four types with distinguishable prognosis were established. Type 1 patients had best prognosis with 69.8% 5-year overall survival (OS), while the type 4 patients had worst prognosis with 42.7% 5-year OS, type 3 and type 2 patients followed. Similarly, the four subgroups had statistically different recurrence free survival (RFS). This classification was significantly associated with HCC recurrence (hazard ratio [HR]:1.492, p<0.001) and long-term survival (HR:1.574, p=0.001). Pathologically, Type 4 correlated with more advanced tumors, such as tumor size and microvascular invasion (vs. type 1/2/3). Moreover, type 4 patients had more severe hepatic inflammation in underlying liver. Conversely, type 1 had active tumor immune microenvironment indicated by more CD8+ T cell infiltration and less PD-L1 expression. In conclusion, baseline HBV-DNA and AST/ALT ratio classification could effectively stratify HBV-related HCC patients with distinguishable prognosis after hepatectomy.
PMID:34464991 | DOI:10.1111/jvh.13606
