Multidisciplinary team-based real-world study of patients with hepatitis B-related liver cancer
10.3760/cma.j.cn112866-20250603-00111
- VernacularTitle:基于多学科联合门诊的乙型肝炎病毒相关肝癌患者的真实世界研究
- Author:
Huimin LIU
1
;
Shilian LI
1
;
Lijian RAN
1
;
Jing WANG
1
;
Wenting CHEN
1
;
Baoyan XU
1
;
Wenting TAN
1
;
Jie XIA
1
;
Qing MAO
1
Author Information
1. 陆军军医大学（第三军医大学）西南医院感染病科 病毒传染病精准防治重庆市重点实验室，重庆 400038
- Publication Type:Journal Article
- Keywords:
Chronic hepatitis B;
Hepatocellular carcinoma;
Multidisciplinary team;
Mortality
- From:
Chinese Journal of Experimental and Clinical Virology
2025;39(4):403-410
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics of patients with hepatitis B virus（HBV）-related primary hepatocellular carcinoma（HCC）who were treated in a multidisciplinary team（MDT）for liver cancer，so as to provide a basis for clinical optimization of the diagnosis and treatment of patients with chronic hepatitis B（CHB）.Methods:A retrospective analysis was performed for 482 HBV-related HCC patients who were treated with HCC-MDT every Thursday afternoon in The First Affiliated Hospital of the Army Medical University from January 2022 to May 2024，aged 18-87（55.54±10.84）years，86.93%（419/482）males and 13.07%（63/482）females. According to the different underlying liver diseases at the time of initial medical treatment and the different prognostic outcomes at the later follow-up，the differences in clinical characteristics between groups under different conditions were compared and analyzed，and the influencing factors of HCC prognosis were understood by Logistic regression analysis. Results:At the time of MDT presentation，the differences in HBeAg status（ χ2=6.311 ，P=0.043），γ-glutamyl traspeptidase（GGT）（ Z=6.277， P=0.043），alkaline phosphatase（ALP）（ Z=7.236 ，P=0.027），and model for end-stage liver disease（MELD）scores（ Z=6.111， P=0.047）among patients with different underlying liver diseases were statistically significant. At follow-up，6.75%（11/163）of HBV-related HCC patients who presented to MDT had a family history of HCC，and their cumulative mortality rate was as high as 60.8%（205/337）at least for 1 year. Mulitivariate Logistic regression analysis showed that different underlying liver disease at the time of initial medical treatment，HBV DNA replication level，MELD score and choice of anti-cancer treatment regimen were the influencing factors for the prognosis of HCC（all P<0.05）. The worse the degree of cirrhosis at the initial presentation，the higher the level of HBV DNA replication，and the higher the MELD score，the worse the prognosis for HCC. Conclusion:Advancing the diagnosis and treatment of CHB，maximizing the inhibition of HBV DNA replication，reducing the MELD score，and optimizing the anti-cancer treatment regimen can reduce the mortality rate of HBV-related HCC.
