1.Multidisciplinary team-based real-world study of patients with hepatitis B-related liver cancer
Huimin LIU ; Shilian LI ; Lijian RAN ; Jing WANG ; Wenting CHEN ; Baoyan XU ; Wenting TAN ; Jie XIA ; Qing MAO
Chinese Journal of Experimental and Clinical Virology 2025;39(4):403-410
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.
2.Efficacy of nucleos(t)ide analogues combined with peginterferon α-2b on antiviral therapy in children with chronic hepatitis B
Wenting CHEN ; Shilian LI ; Xiaochen MA ; Fang CHEN ; Lijian RAN ; Yi WU ; Yan GUO ; Yan ZHU ; Qing MAO ; Huimin LIU
Chinese Journal of Experimental and Clinical Virology 2025;39(4):411-418
Objective:To analyze the efficacy of combination of peginterferon α-2b(Peg-IFN α-2b)with nucleos(t)ide analogues(NAs)on antiviral therapy in children with chronic hepatitis B(CHB)and to provide an optimized clinical treatment strategies for CHB children.Methods:A retrospective analysis was conducted on 30 CHB children treated in The First Affiliated Hospital of the Army Medical University(Southwest Hospital)from January 2022 to January 2025 with treatment duration at least 48 weeks. The enrolled children were aged between 2 and 17 years and divided into the NAs combined with Peg-IFN α-2b(NPI)group(n=13)and NAs group(n=17)by their therapy regimens. The characteristics of baseline,week 12,week 24,week 48 and week 96 were compared between groups,as well as the differences in response to biochemical,immune and viral indicators at each observation point. Logistic regression analysis and receiver operating characteristic(ROC)curve analysis were performed to identify factors influencing the HBsAg seroclearance. Results:At baseline of treatment,the proportion of HBeAg positivity in the NPI group and the NAs group was high(76.9% vs 86.6%, χ2=0.679, P=0.628),and the alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in the NPI group were significantly lower than those in the NAs group( P<0.001). At 24 weeks,the decrease in HBsAg in the NPI group was also significantly higher than that in the NAs group( Z=-3.161, P=0.002). Finally,the cumulative seroclearance rate of HBsAg at 96 weeks in the NPI group was significantly higher than that in the NAs group(46.15% vs 5.88%, χ2=0.679, P=0.025). Mulitivariate Logistic regression analysis showed that treatment regimen and gender were risk factors affecting the outcome of HBsAg( P<0.05). ROC curve analysis showed that the increase in ALT at 12 weeks compared with baseline(AUC=0.857,Cutoff value=3.615 IU/L),the decrease in ALT at 24 weeks(AUC=0.870,Cutoff value=47.85 IU/L),and the decrease in HBsAg at 12 weeks and especially at 24 weeks(AUC=0.885,Cutoff value=0.97log IU/ml)were effective predictors of HBsAg prognosis at 96 weeks. Conclusion:In CHB children,antiviral regimen Peg-IFN α-2b combined with NAs was more effective than NAs alone in improving the HBsAg seroclearance rate of CHB,and the effects in female were better than in male. The decline of HBsAg and the fluctuation of ALT in the early treatment period are valid predictors of HBsAg clearance.
3.Multidisciplinary team-based real-world study of patients with hepatitis B-related liver cancer
Huimin LIU ; Shilian LI ; Lijian RAN ; Jing WANG ; Wenting CHEN ; Baoyan XU ; Wenting TAN ; Jie XIA ; Qing MAO
Chinese Journal of Experimental and Clinical Virology 2025;39(4):403-410
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.
4.Efficacy of nucleos(t)ide analogues combined with peginterferon α-2b on antiviral therapy in children with chronic hepatitis B
Wenting CHEN ; Shilian LI ; Xiaochen MA ; Fang CHEN ; Lijian RAN ; Yi WU ; Yan GUO ; Yan ZHU ; Qing MAO ; Huimin LIU
Chinese Journal of Experimental and Clinical Virology 2025;39(4):411-418
Objective:To analyze the efficacy of combination of peginterferon α-2b(Peg-IFN α-2b)with nucleos(t)ide analogues(NAs)on antiviral therapy in children with chronic hepatitis B(CHB)and to provide an optimized clinical treatment strategies for CHB children.Methods:A retrospective analysis was conducted on 30 CHB children treated in The First Affiliated Hospital of the Army Medical University(Southwest Hospital)from January 2022 to January 2025 with treatment duration at least 48 weeks. The enrolled children were aged between 2 and 17 years and divided into the NAs combined with Peg-IFN α-2b(NPI)group(n=13)and NAs group(n=17)by their therapy regimens. The characteristics of baseline,week 12,week 24,week 48 and week 96 were compared between groups,as well as the differences in response to biochemical,immune and viral indicators at each observation point. Logistic regression analysis and receiver operating characteristic(ROC)curve analysis were performed to identify factors influencing the HBsAg seroclearance. Results:At baseline of treatment,the proportion of HBeAg positivity in the NPI group and the NAs group was high(76.9% vs 86.6%, χ2=0.679, P=0.628),and the alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in the NPI group were significantly lower than those in the NAs group( P<0.001). At 24 weeks,the decrease in HBsAg in the NPI group was also significantly higher than that in the NAs group( Z=-3.161, P=0.002). Finally,the cumulative seroclearance rate of HBsAg at 96 weeks in the NPI group was significantly higher than that in the NAs group(46.15% vs 5.88%, χ2=0.679, P=0.025). Mulitivariate Logistic regression analysis showed that treatment regimen and gender were risk factors affecting the outcome of HBsAg( P<0.05). ROC curve analysis showed that the increase in ALT at 12 weeks compared with baseline(AUC=0.857,Cutoff value=3.615 IU/L),the decrease in ALT at 24 weeks(AUC=0.870,Cutoff value=47.85 IU/L),and the decrease in HBsAg at 12 weeks and especially at 24 weeks(AUC=0.885,Cutoff value=0.97log IU/ml)were effective predictors of HBsAg prognosis at 96 weeks. Conclusion:In CHB children,antiviral regimen Peg-IFN α-2b combined with NAs was more effective than NAs alone in improving the HBsAg seroclearance rate of CHB,and the effects in female were better than in male. The decline of HBsAg and the fluctuation of ALT in the early treatment period are valid predictors of HBsAg clearance.
5.Preliminary study of cardiac morphology and function in fetuses with tetralogy of Fallot using fetal heart quantification
Lijian HUANG ; Bowen ZHAO ; Xiaoxi LU ; Mei PAN ; Xiaohui PENG ; Ran CHEN ; Yang CHEN
Chinese Journal of Ultrasonography 2023;32(3):189-197
Objective:To evaluate the fetal heart shape and function in tetralogy of Fallot (TOF) by fetal heart quantitative analysis (fetal HQ).Methods:A total of 52 fetuses with TOF diagnosed by fetal echocardiography and 200 normal fetuses matched with their gestational weeks from March 2020 to March 2022 at Sir Run Run Shaw Hospital, Zhejiang University were retrospectively evaluated. The basic parameters of fetal cardiac blood vessels in the two groups were measured by fetal HQ technology and conventional M-mode ultrasound technology: aortic valve diameter(AV), pulmonary artery valve diameter(PV), main pulmonary artery diameter (MPA) and Z-score. The overall morphometric measurements including end-diastolic length diameter, transverse diameter, area, and global spherical index (GSI) of the fetal heart in the 4-chamber view(4CV), area and length of the right and left ventricles and their ratios. Measurements of left and right ventricular function included ejection fraction (EF), fraction area change rate (FAC), tricuspid annular plane systolic excursion (TAPSE), left and right ventricular global longitudinal strain (GLS), and left and right ventricular end-diastolic diameter (ED), spherical index (SI), and fractional shortening rate (FS) of 24-segments. The differences of above parameters between TOF group and control group were compared. In addition, the relationships between the absolute value of left and right ventricular GLS of TOF fetus and PV/AV, PV Z-score and MPA Z-score were analyzed. The optimal critical values of GSI, left ventricular EF and left ventricular FAC of TOF fetus were determined by ROC curve, and their corresponding sensitivity and specificity were obtained.Results:Compared with control group, there were significant differences in 4CV end-diastolic length, area, GSI, left ventricular area, left ventricular length, left ventricular EF, left ventricular FAC and left ventricular GLS in TOF group (all P<0.05). There were significant differences in ED between left ventricular 15-24 segments and right ventricular 1-21 segments (all P<0.05). There were significant differences in SI between left ventricular 1-16 segments, 21-24 segments and all segments of right ventricle (all P<0.05). The differences in FS were statistically significant (all P<0.05) when comparing all segments of the left ventricle and 1-2 segments of the right ventricular, and the remaining parameters were not statistically significant (all P>0.05). The left ventricular GLS absolute value of TOF fetuses was positively correlated with PV/AV, PV Z-score and MPA Z-score( rs=0.338, 0.441 and 0.458, all P<0.05), the right ventricular GLS absolute value of TOF fetuses was positively correlated with PV AV, PV Z-score and MPA Z-score( rs=0.418, 0.368 and 0.338, all P<0.05). The optimal critical values of GSI, left ventricular EF, and left ventricular FAC in the diagnosis of fetal TOF were 1.19, 59.05%, and 44.4%, respectively. At this time, the sensitivities of diagnosis of TOF were 0.78, 0.75, and 0.80, respectively. The specificities were 0.88, 0.88 and 0.83, respectively. The areas under ROC curve were 0.89, 0.88 and 0.89, respectively. Conclusions:Fetal HQ technology can provide a simple and reliable quantitative evaluation of fetal heart shape and function, and provide certain theoretical parameters for the study of fetal heart shape and function.

Result Analysis
Print
Save
E-mail