Clinical Research Papers:
Is chronic hepatitis B infection a protective factor for the progression of advanced pancreatic ductal adenocarcinoma? An analysis from a large multicenter cohort study
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Qiwen Chen1,2,*, Zhouyu Ning1,*, Lei Wang3,*, Haifeng Ying4,*, Shu Dong1,*, Chenyue Zhang 1,*, Xiaoheng Shen4, Yuanbiao Guo4, Hao Chen1, Xiaoyan Zhu1, Yehua Shen1, Weidong Shi1, Yongqiang Hua1, Kun Wang1, Junhua Lin1, Litao Xu1, Lianyu Chen1, Lanyun Feng1, Xiumei Zhang1, Jing Xie1, Bo Sun5, Yaqin Sun6, Wenchao Gu6, Mei Kang2, Zheng Tang2, Zhujun Chen7, Zhen Chen1, Luming Liu1, Jinming Yu2, Zhaoshen Li3 and Zhiqiang Meng1
1 Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China
2 Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
3 Digestive Endoscopy Center, Department of Gastroenterology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
4 Department of Integrative Medicine of Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
5 Department of Endoscopy and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China
6 Department of Radiology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China
7 Department of Clinical Laboratory and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China
* These authors have contributed equally to this study
Zhiqiang Meng, email:
Zhaoshen Li, email:
Jinming Yu, email:
Keywords: pancreatic adenocarcinoma, HBV
Received: March 29, 2016 Accepted: July 10, 2016 Published: November 01, 2016
Purpose: Whether the progression of advanced pancreatic ductal adenocarcinoma (PDAC) patients could be affected by HBV exposure remains to be determined. Therefore, we conducted this study to assess the effect of HBV infection on PDAC progression among a large cohort in China.
Methods: A multicenter cohort study was conducted to explore whether liver metastasis and overall survival in locally advanced and metastatic PDAC could be affected by HBV infection. In this study, we collected 1,526 advanced PDAC patients at three participating hospitals - Shanghai Cancer Center, Changhai Hospital and Ruijin Hospital from 2004 to 2013. The association between HBV status and advanced PDAC progression was then examined.
Results: In multivariable Logistic regression model, chronic hepatitis B(CHB) infection was inversely associated with synchronous liver metastasis compared to non HBV infection (OR 0.41, 95% CI 0.19-0.85) for stage IV patients. In a multivariable Cox model, CHB infection (HR=0.11, 95% CI 0.02-0.82) is considered as a protective factor of metachronous liver metastasis compared to Non HBV infection for stage III patients. For stage IV patients, CHB infection was inversely associated with overall survival compared to non HBV infection (HR 0.70, 95% CI 0.51-0.95). Inactive carrier(IC) and resolved HBV infection showed no significant association with survival compared to non HBV infection.
Conclusion: This study indicated that CHB infection may serve as an independent factor which decrease synchronous or metachronous liver metastasis, and increase overall survival among advanced PDAC patients.
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