Hepatitis B virus infection: a favorable prognostic factor for intrahepatic cholangiocarcinoma after resection

Abstract

Aim: To study the prognostic factors for intrahepatic cholangiocarcinoma (ICC) and evaluate the impact of chronic hepatitis B virus (HBV) infection on survival rate of ICC patients.

Methods: A total of 155 ICC patients who underwent macroscopic curative resections (R0 and R1) were enrolled in this retrospective study and divided into group A with HBV infection and group B without HBV infection according to their chronic HBV infection, represented by positive hepatitis B surface antigen (HBsAg) in serum or in liver tissue. Clinicopathological characteristics and survival rate of the patients were evaluated.

Results: All patients underwent anatomical resection. Their 1- and 3-year survival rates were 60.6% and 32.1%, respectively. Multivariate analyses revealed that HBV infection, hepatolithiasis, microscopic satellite lesion, and lymphatic metastasis were the independent prognostic factors for the survival rate of ICC patients. The median disease-free survival time of the patients was 5.0 mo. The number of tumors, microscopic satellite lesion, and vascular invasion were the independent prognostic factors for the disease-free survival rate of the patients. The prognostic factors affecting the survival rate of ICC patients with HBV infection and those without HBV infection were not completely consistent. Alkaline phosphatase > 119 U/L, microscopic satellite lesion, vascular invasion, and lymphatic metastasis were the independent factors for the patients with HBV infection, while r-glutamyltransferase > 64 U/L, microscopic satellite lesion, and poor tumor differentiation were the independent factors for the patients without HBV infection.

Conclusion: HBV infection is a valuable clinical factor for predicting tumor invasiveness and clinical outcome of ICC patients. ICC patients with HBV infection should be distinguished from those without HBV infection because they have different clinicopathological characteristics, prognostic factors and outcomes after surgical resection.

Keywords: Hepatitis B virus; Intrahepatic cholangiocarcinoma; Prognosis; Survival.

Figure 1

Overall and disease-free survival rates of patients with intrahepatic cholangiocarcinoma after surgical resection (A), higher survival rate of intrahepatic cholangiocarcinoma patients with hepatitis B virus infection than that of those without hepatitis B virus infection (B), significantly poorer survival rate of intrahepatic cholangiocarcinoma patients with lymphatic metastasis than that of those without lymphatic metastasis (C), significantly poorer survival rate of intrahepatic cholangiocarcinoma patients with microscopic satellite lesion than that of those without microscopic satellite lesion (D), and significantly poorer survival rate of intrahepatic cholangiocarcinoma patients with hepatolithiasis than that of those without hepatolithiasis (E).

Figure 2

Adjusted survival curves according to the independent prognostic factors by multivariate analysis (Cox model) for intrahepatic cholangiocarcinoma with hepatitis B virus infection after resection. A: Alkaline phosphatase (ALP); B: Microscopic satellite lesion; C: Vascular invasion; D: Lymphatic metastasis.

Figure 3

Adjusted survival curves according to the independent prognostic factors by multivariate analysis (Cox model) for intrahepatic cholangiocarcinoma without hepatitis B virus infection after resection. A: R-glutamyltransferase (r-GT); B: Microscopic satellite lesion; C: Tumor differentiation.