Original Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Mar 14, 2011; 17(10): 1292-1303
Published online Mar 14, 2011. doi: 10.3748/wjg.v17.i10.1292
Hepatitis B virus infection: A favorable prognostic factor for intrahepatic cholangiocarcinoma after resection
Hua-Bang Zhou, Hui Wang, Yu-Qiong Li, Shuang-Xi Li, Hao Wang, Dong-Xun Zhou, Qian-Qian Tu, Qing Wang, Shan-Shan Zou, Meng-Chao Wu, He-Ping Hu
Hua-Bang Zhou, Hui Wang, Yu-Qiong Li, Shuang-Xi Li, Hao Wang, Dong-Xun Zhou, Qian-Qian Tu, Qing Wang, Shan-Shan Zou, Meng-Chao Wu, He-Ping Hu, Department of Comprehensive Treatment II, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200433, China
Author contributions: Zhou HB, Hu HP and Wu MC designed the study; Zhou HB, Li YQ, Wang H, Li SX and Tu QQ performed the study; Wang H, Zhou DX, Wang Q, Zou SS analyzed the data; Zhou HB, Wang H and Hu HP wrote the paper.
Correspondence to: He-Ping Hu, Professor, Department of Comprehensive Treatment II, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200433, China. hp-hu@medmail.com.cn
Telephone: +86-21-81875141   Fax: +86-21-81875141
Received: September 20, 2010
Revised: December 30, 2010
Accepted: January 6, 2011
Published online: March 14, 2011
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: Intrahepatic cholangiocarcinoma; Hepatitis B virus; Survival; Prognosis