Yang DH, Wang WP, Zhang Q, Pan HY, Huang YC, Zhang JJ. Hepatocellular carcinoma progression in hepatitis B virus-related cirrhosis patients receiving nucleoside (acid) analogs therapy: A retrospective cross-sectional study. World J Gastroenterol 2021; 27(17): 2025-2038 [PMID: 34007137 DOI: 10.3748/wjg.v27.i17.2025]
Corresponding Author of This Article
Dan-Hong Yang, PhD, Chief Doctor, Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. ydh-11@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 7, 2021; 27(17): 2025-2038 Published online May 7, 2021. doi: 10.3748/wjg.v27.i17.2025
Hepatocellular carcinoma progression in hepatitis B virus-related cirrhosis patients receiving nucleoside (acid) analogs therapy: A retrospective cross-sectional study
Dan-Hong Yang, Hong-Ying Pan, Yi-Cheng Huang, Jia-Jie Zhang, Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
Wei-Ping Wang, Qiang Zhang, Postgraduate Department, Bengbu Medical College, Bengbu 233030, Anhui Province, China
Author contributions: Yang DH designed the research study; Yang DH and Wang WP analyzed the data and wrote the manuscript; Zhang Q, Pan HY, Huang YC and Zhang JJ collected the data; All authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Zhejiang Provincial People’s Hospital (2020QT155, Hangzhou, Zhejiang Province, China).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dan-Hong Yang, PhD, Chief Doctor, Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. ydh-11@163.com
Received: January 31, 2021 Peer-review started: January 31, 2021 First decision: March 14, 2021 Revised: March 25, 2021 Accepted: April 2, 2021 Article in press: April 2, 2021 Published online: May 7, 2021 Processing time: 87 Days and 13.2 Hours
ARTICLE HIGHLIGHTS
Research background
Antiviral therapy cannot completely block the progression of hepatitis B to hepatocellular carcinoma (HCC). Furthermore, there are few early predictors of HCC progression and early identification is difficult in patients with HBV-related cirrhosis who receive nucleos(t)ide analog (NA) therapy. The study is helpful to provide HCC prevention and control strategies by analyzing the risk factors of HCC progression and the diagnostic value of AFP for HCC in those people.
Research motivation
The study objective was to identify factors that affect the occurrence of HCC and how to identify early HCC in patients with hepatitis B virus (HBV)-related cirrhosis who receive NA therapy. The results can improve the understanding of the development of HCC in those patients so as to improve the early detection and prevention of HCC.
Research objectives
The study objectives were to clarify risk factors and the diagnostic value of alpha-fetoprotein (AFP) for HCC progression in patients with HBV-related cirrhosis treated with NAs and to provide new strategies for prevention and control of HCC in those patients.
Research methods
Logistic regression analysis was used to analyze the risk factors of HCC progression. The diagnostic value of AFP for HCC was evaluated by receiver operating chara-cteristic curve analysis.
Research results
The study showed that age ≥ 60 years, smoking history, family history of HCC, lamivudine resistance, HBV DNA negativity, fasting blood sugar ≥ 6.16 mmol/L were independent risk factors of HCC progression. Serum AFP had limited diagnostic value for HCC. The results provide a meaningful strategy for early prediction and identification for HCC in those patients.
Research conclusions
A retrospective cross-sectional study was conducted to analyze risk factors of HCC progression in HBV-related cirrhosis patients receiving NA therapy. Metabolic effects of fasting blood sugar levels on the progress of HCC were seen during the receipt of NA therapy. The diagnostic value of the serum AFP level was evaluated in those patients.
Research perspectives
The study results will change the strategies used to prevent HCC in patients with HBV-related cirrhosis an receive NA therapy.
