Abstract
BackgroundThere have been controversial voices on if hepatitis B virus infection decreases the risk of colorectal liver metastases or not. This study aims to the find the association between HBV infection and postoperative survival of colorectal cancer and the risk of liver metastases in colorectal cancer patients.MethodsPatients who underwent curative surgical resection for colorectal cancer between January 2011 and December 2012 were included. Patients were grouped according to anti-HBc. Differences in overall survival, time to progress, and hepatic metastasis-free survival between groups and significant predictors were analyzed.ResultsThree hundred twenty-seven colorectal cancer patients were comprised of 202 anti-HBc negative cases and 125 anti-HBc positive cases, and anti-HBc positive cases were further divided into high-titer anti-HBc group (39) and low-titer anti-HBc group (86). The high-titer anti-HBc group had significantly worse overall survival (5-Yr, 65.45% vs. 80.06%; P < .001), time to progress (5-Yr, 44.26% vs. 84.73%; P < .001), and hepatic metastasis-free survival (5-Yr, 82.44% vs. 94.58%; P = .029) than the low-titer group. Multivariate model showed anti-HBc ≥ 8.8 S/CO was correlated with poor overall survival (HR, 3.510; 95% CI, 1.718–7.17; P < .001), time to progress (HR, 5.747; 95% CI, 2.789–11.842; P < .001), and hepatic metastasis-free survival (HR, 3.754; 95% CI, 1.054–13.369; P = .041) in the anti-HBc positive cases.ConclusionsHigher titer anti-HBc predicts a potential higher risk of liver metastases and a worse survival in anti-HBc positive colorectal cancer patients.
Highlights
There have been controversial voices on if hepatitis B virus infection decreases the risk of colorectal liver metastases or not
It was expounded that the leukocytes infiltrated in tumor tissue could generate inflammatory mediators, thereby forming inflammatory microenvironment in tumor tissue which was further founded to stimulate the development of tumor [5,6,7]
The 125 anti-HBc positive cases were divided into two groups according to optimal cut-off point of anti-HBc titer (8.8 S/CO): 39 (31.2%) cases were classified into the high-titer anti-HBc group, while the remaining 86 (68.8%) cases were classified into the low-titer anti-HBc group
Summary
There have been controversial voices on if hepatitis B virus infection decreases the risk of colorectal liver metastases or not. This study aims to the find the association between HBV infection and postoperative survival of colorectal cancer and the risk of liver metastases in colorectal cancer patients. Colorectal cancer (CRC) is the third most common carcinoma in the world [1]. Inflammation has close relationship with the forming of tumor. It was expounded that the leukocytes infiltrated in tumor tissue could generate inflammatory mediators, thereby forming inflammatory microenvironment in tumor tissue which was further founded to stimulate the development of tumor [5,6,7]. Chronic inflammation could be sustained by the longterm activity of harmful microorganisms in the human body [8, 9], which may promote tumor formation and development
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