Isolated anti-HBc is an independent risk factor for tumor recurrence in intrahepatic cholangiocarcinoma after curative resection

Xiao-Bo Xu; Chen Hu; Han-Jin Yang; Shu-Sen Zheng

doi:10.1016/j.hbpd.2022.07.010

Isolated anti-HBc is an independent risk factor for tumor recurrence in intrahepatic cholangiocarcinoma after curative resection

Hepatobiliary Pancreat Dis Int. 2022 Oct;21(5):472-478. doi: 10.1016/j.hbpd.2022.07.010. Epub 2022 Aug 1.

Authors

Xiao-Bo Xu¹, Chen Hu², Han-Jin Yang³, Shu-Sen Zheng⁴

Affiliations

¹ Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; Key Laboratory of Pulsed Power Translational Medicine of Zhejiang Province, Hangzhou 310012, China.
² Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
³ Department of Pathology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
⁴ Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; Key Lab of Combined Multi-Organ Transplantation, Ministry of Public Health, Hangzhou 310003, China. Electronic address: shusenzheng@zju.edu.cn.

PMID: 35948505
DOI: 10.1016/j.hbpd.2022.07.010

Abstract

Background: Intrahepatic cholangiocarcinoma (ICC) is a poorly understood and aggressive malignancy with increasing incidence and mortality. Hepatitis B virus (HBV) infection is recognized as one of the important risk factors of ICC. There are few reports focusing on whether isolated antibody to hepatitis B core antigen (isolated anti-HBc, IAHBc) have prognostic role in ICC, while positive hepatitis B surface antigen (HBsAg) has been reported to be associated with the prognosis of ICC. The aim of this study was to investigate the prognostic value of IAHBc in ICC patients after curative resection, in order to identify those who have the high risk of ICC recurrence in the early stage.

Methods: We divided 209 ICC patients who underwent curative resection into 4 groups: group I (n = 40), HBsAg (-)/antibody to hepatitis B surface antigen (anti-HBs) (-)/anti-HBc (+); group II (n = 70), HBsAg (+)/anti-HBc (-); group III (n = 55), HBsAg (-)/anti-HBs (+)/anti-HBc (+); and group IV (n = 44), HBsAg (-)/anti-HBc (-). We compared the recurrence-free survival (RFS) and overall survival (OS) among these four groups.

Results: The median follow-up time was 16.93 months (range 1-34.6 months). The 1- and 2-year RFS and OS rates were 60% and 42%, and 78% and 63% respectively in all patients. Compared to the whole non-IAHBc patients (group II + group III + group IV), IAHBc patients (group I) showed significantly lower RFS at 1 year (39.8% vs. 64.4%, P = 0.001) and 2 years (20.7% vs. 46.7%, P = 0.001). When compared to other three individual groups, IAHBc patients (group I) also had the lowest RFS. We did not find significant difference in OS among the four groups. Further multivariate analysis revealed that IAHBc was an independent risk factor of RFS.

Conclusions: IAHBc is an independent poor prognostic factor for tumor recurrence in ICC patients after curative resection.

Keywords: Cholangiocarcinoma; Hepatitis B virus; Isolated antibody to hepatitis B core antigen; Occult hepatitis B infection.

MeSH terms

Bile Duct Neoplasms* / surgery
Bile Ducts, Intrahepatic
Cholangiocarcinoma* / pathology
Hepatitis B Antibodies
Hepatitis B Core Antigens
Hepatitis B Surface Antigens
Hepatitis B virus
Hepatitis B* / complications
Hepatitis B* / diagnosis
Hepatitis B* / epidemiology
Humans
Neoplasm Recurrence, Local
Risk Factors

Substances

Hepatitis B Antibodies
Hepatitis B Core Antigens
Hepatitis B Surface Antigens