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Zhao J, Fang L, Pu R, Liu W, Cai S, Wang R, Shi Y, Li Z, Zhang Z, Li Z, Cao G. Androgen receptor-induced molecules and androgen contribute synergistically to male-predominance of hepatocellular carcinoma. iScience 2024; 27:110519. [PMID: 39156638 PMCID: PMC11326917 DOI: 10.1016/j.isci.2024.110519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/30/2024] [Accepted: 07/12/2024] [Indexed: 08/20/2024] Open
Abstract
We aimed to clarify the mechanisms of male predominance of hepatitis B virus (HBV) -related hepatocellular carcinoma (HCC). Androgen receptor (AR) facilitates HCC cell growth, which was augmented by androgen (dihydrotestosterone [DHT]) and attenuated by anti-androgen (flutamide). AR upregulated the expressions of BIRC7, IGFBP3, and NTSR1 via increasing their promoter activities, which were enhanced by DHT. Wild-type HBV X (WT-HBx) upregulated AR transcription, which depended on DHT; whereas the effect of C-terminal carboxy-truncated HBx on AR transcription was independent of DHT. BIRC7, IGFBP3, and NTSR1 increased the growth of HCC. High expression of BIRC7 and NTSR1 contributes to poor HCC outcomes in male patients, but not in female patients. Downregulation of NTSR1 inhibits tumor growth in male mice rather than in female mice. Conclusively, AR promotes HCC at least partially via upregulating BIRC7, IGFBP3, and NTSR1, which is enhanced by androgen and HBx. BIRC7 and NTSR1 facilitate HCC progression in a male-predominant manner.
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Affiliation(s)
- Jiayi Zhao
- Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
- Key Laboratory of Biological Defense, Ministry of Education, Second Military Medical University, Shanghai 200433, China
- Shanghai Key Laboratory of Medical Bioprotection, Second Military Medical University, Shanghai 200433, China
| | - Letian Fang
- Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
- Key Laboratory of Biological Defense, Ministry of Education, Second Military Medical University, Shanghai 200433, China
- Shanghai Key Laboratory of Medical Bioprotection, Second Military Medical University, Shanghai 200433, China
| | - Rui Pu
- Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
- Key Laboratory of Biological Defense, Ministry of Education, Second Military Medical University, Shanghai 200433, China
- Shanghai Key Laboratory of Medical Bioprotection, Second Military Medical University, Shanghai 200433, China
| | - Wenbin Liu
- Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
- Key Laboratory of Biological Defense, Ministry of Education, Second Military Medical University, Shanghai 200433, China
- Shanghai Key Laboratory of Medical Bioprotection, Second Military Medical University, Shanghai 200433, China
| | - Shiliang Cai
- Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
- Key Laboratory of Biological Defense, Ministry of Education, Second Military Medical University, Shanghai 200433, China
- Shanghai Key Laboratory of Medical Bioprotection, Second Military Medical University, Shanghai 200433, China
| | - Ruihua Wang
- Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
- Key Laboratory of Biological Defense, Ministry of Education, Second Military Medical University, Shanghai 200433, China
- Shanghai Key Laboratory of Medical Bioprotection, Second Military Medical University, Shanghai 200433, China
| | - Yiwei Shi
- Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
- Key Laboratory of Biological Defense, Ministry of Education, Second Military Medical University, Shanghai 200433, China
- Shanghai Key Laboratory of Medical Bioprotection, Second Military Medical University, Shanghai 200433, China
| | - Zheng Li
- Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
- Key Laboratory of Biological Defense, Ministry of Education, Second Military Medical University, Shanghai 200433, China
- Shanghai Key Laboratory of Medical Bioprotection, Second Military Medical University, Shanghai 200433, China
| | - Zihan Zhang
- Tongji University School of Medicine, Tongji University, Shanghai 200120, China
| | - Zishuai Li
- Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
- Key Laboratory of Biological Defense, Ministry of Education, Second Military Medical University, Shanghai 200433, China
- Shanghai Key Laboratory of Medical Bioprotection, Second Military Medical University, Shanghai 200433, China
| | - Guangwen Cao
- Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
- Key Laboratory of Biological Defense, Ministry of Education, Second Military Medical University, Shanghai 200433, China
- Shanghai Key Laboratory of Medical Bioprotection, Second Military Medical University, Shanghai 200433, China
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Zhao Y, Chen K, Yang H, Zhang F, Ding L, Liu Y, Zhang L, Zhang Y, Wang H, Deng Y. HLA-DR genetic polymorphisms and hepatitis B virus mutations affect the risk of hepatocellular carcinoma in Han Chinese population. Virol J 2023; 20:283. [PMID: 38037048 PMCID: PMC10691135 DOI: 10.1186/s12985-023-02253-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/26/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Human leucocyte antigen (HLA)-DR plays a crucial role in the immune response against hepatitis B virus (HBV). We aimed to investigate the associations of HLA-DR single nucleotide polymorphisms (SNPs) with the generation of hepatocellular carcinoma (HCC)-related HBV mutations. The effects of HLA-DR SNPs and their interactions with HBV mutations on HCC risks were also determined. METHODS Five HLA-DR SNPs (rs3135363, rs9268644, rs35445101, rs24755213, and rs984778) were genotyped in 792 healthy controls, 586 chronic hepatitis B (CHB) patients, 536 liver cirrhosis (LC) patients, and 1500 HCC patients using quantitative PCR. Sanger sequencing was used to identify the HBV mutations. Logistic regression model was performed to evaluate the association of HLA-DR SNPs with HCC risk and the frequencies of HCC-related HBV mutations. RESULTS The variant genotypes at rs3135363, rs9268644, rs35445101, rs24755213, and rs984778 were associated with decreased HCC risks. In genotype C HBV-infected subjects, variant genotypes of these SNPs were associated with decreased frequencies of HCC-related HBV mutations such as C1653T, T1674C/G, G1719T, T1753A/C, A1762T/G1764A, A1846T, G1896A, G1899A, and preS deletion. AG genotype at rs3135363, CA genotype at rs9268644, and AG genotype at rs24755213 reduced the generation of T1753A/C and G1896A in genotype B HBV-infected subjects, respectively. In addition, the interactions of rs3135363, rs9268644, rs24755213 with C1653T, T1753A/C, A1846T, and G1896A decreased the risks of HCC. CONCLUSIONS HLA-DR genetic polymorphisms might predispose the host to immunoselection of HCC-related HBV mutations and affect the HCC risks possibly through interacting with HBV mutations.
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Affiliation(s)
- Yubao Zhao
- Department of Infectious Diseases, Second Affiliated Hospital of Shandong First Medical University, 706 Taishan Street, Tai'an, Shandong Province, China
| | - Kun Chen
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 6699 Qingdao Road, Jinan, Shandong Province, China
| | - Hui Yang
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 6699 Qingdao Road, Jinan, Shandong Province, China
| | - Feng Zhang
- Department of Gastrointestinal Surgery, Tai'an Central Hospital, 29 Longtan Road, Tai'an, Shandong Province, China
| | - Lu Ding
- Department of Public Health, Jinan Central Hospital, 105 Jiefang Road, Jinan, Shandong Province, China
| | - Yan Liu
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 6699 Qingdao Road, Jinan, Shandong Province, China
| | - Le Zhang
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 6699 Qingdao Road, Jinan, Shandong Province, China
| | - Yuchen Zhang
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 6699 Qingdao Road, Jinan, Shandong Province, China
| | - Huiliang Wang
- Department of Infectious Diseases, Second Affiliated Hospital of Shandong First Medical University, 706 Taishan Street, Tai'an, Shandong Province, China
| | - Yang Deng
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 6699 Qingdao Road, Jinan, Shandong Province, China.
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Niu Z, Jiang D, Shen J, Liu W, Tan X, Cao G. Potential Role of the Fragile Histidine Triad in Cancer Evo-Dev. Cancers (Basel) 2023; 15:cancers15041144. [PMID: 36831487 PMCID: PMC9954361 DOI: 10.3390/cancers15041144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
Cancer development follows an evolutionary pattern of "mutation-selection-adaptation" detailed by Cancer Evolution and Development (Cancer Evo-Dev), a theory that represents a process of accumulating somatic mutations due to the imbalance between the mutation-promoting force and the mutation-repairing force and retro-differentiation of the mutant cells to cancer initiation cells in a chronic inflammatory microenvironment. The fragile histidine triad (FHIT) gene is a tumor suppressor gene whose expression is often reduced or inactivated in precancerous lesions during chronic inflammation or virus-induced replicative stress. Here, we summarize evidence regarding the mechanisms by which the FHIT is inactivated in cancer, including the loss of heterozygosity and the promoter methylation, and characterizes the role of the FHIT in bridging macroevolution and microevolution and in facilitating retro-differentiation during cancer evolution and development. It is suggested that decreased FHIT expression is involved in several critical steps of Cancer Evo-Dev. Future research needs to focus on the role and mechanisms of the FHIT in promoting the transformation of pre-cancerous lesions into cancer.
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Affiliation(s)
- Zheyun Niu
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine Tongji University, Shanghai 200120, China
| | - Dongming Jiang
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine Tongji University, Shanghai 200120, China
| | - Jiaying Shen
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine Tongji University, Shanghai 200120, China
| | - Wenbin Liu
- Shanghai Key Laboratory of Medical Bioprotection, Shanghai 200433, China
- Key Laboratory of Biological Defense, Ministry of Education, Shanghai 200433, China
- Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
| | - Xiaojie Tan
- Shanghai Key Laboratory of Medical Bioprotection, Shanghai 200433, China
- Key Laboratory of Biological Defense, Ministry of Education, Shanghai 200433, China
- Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
| | - Guangwen Cao
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine Tongji University, Shanghai 200120, China
- Shanghai Key Laboratory of Medical Bioprotection, Shanghai 200433, China
- Key Laboratory of Biological Defense, Ministry of Education, Shanghai 200433, China
- Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
- Correspondence: ; Tel.: +86-21-81871060
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Hepatitis Virus and Hepatocellular Carcinoma: Recent Advances. Cancers (Basel) 2023; 15:cancers15020533. [PMID: 36672482 PMCID: PMC9856776 DOI: 10.3390/cancers15020533] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/08/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
Hepatocellular carcinoma (HCC) remains a global health challenge, causing 600,000 deaths each year. Infectious factors, including hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis D virus (HDV), have long been considered the major risk factors for the development and progression of HCC. These pathogens induce hepatocyte transformation through a variety of mechanisms, including insertional mutations caused by viral gene integration, epigenetic changes, and the induction of long-term immune dysfunction. The discovery of these mechanisms, while advancing our understanding of the disease, also provides targets for new diagnostic and therapeutic approaches. In addition, the discovery and research of chronic HEV infection over the past decade indicate that this common hepatitis virus also seems to have the potential to induce HCC. In this review, we provide an overview of recent studies on the link between hepatitis virus and HCC, as well as new diagnostic and therapeutic approaches to HCC based on these findings. Finally, we also discuss the potential relationship between HEV and HCC. In conclusion, these associations will further optimize the diagnosis and treatment of infection-associated HCC and call for better management policies.
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Identification of Estradiol Benzoate as an Inhibitor of HBx Using Inducible Stably Transfected HepG2 Cells Expressing HiBiT Tagged HBx. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27155000. [PMID: 35956950 PMCID: PMC9370419 DOI: 10.3390/molecules27155000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022]
Abstract
HBx plays a significant role in the cccDNA epigenetic modification regulating the hepatitis B virus (HBV) life cycle and in hepatocyte proliferation and carcinogenesis. By using the sleeping-beauty transposon system, we constructed a tetracycline-induced HBx-expressing stable cell line, SBHX21. HBx with a HiBiT tag can be quickly detected utilizing a NanoLuc-based HiBiT detection system. By screening a drug library using SBHX21 cells, we identified estradiol benzoate as a novel anti-HBx agent. Estradiol benzoate also markedly reduced the production of HBeAg, HBsAg, HBV pgRNA, and HBV DNA in a dose-dependent manner, suggesting that estradiol benzoate could be an anti-HBV agent. Docking model results revealed that estradiol benzoate binds to HBx at TRP87 and TRP107. Collectively, our results suggest that estradiol benzoate inhibits the HBx protein and HBV transcription and replication, which may serve as a novel anti-HBV molecular compound for investigating new treatment strategies for HBV infection.
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Liu W, Cai S, Pu R, Li Z, Liu D, Zhou X, Yin J, Chen X, Chen L, Wu J, Tan X, Wang X, Cao G. HBV preS Mutations Promote Hepatocarcinogenesis by Inducing Endoplasmic Reticulum Stress and Upregulating Inflammatory Signaling. Cancers (Basel) 2022; 14:cancers14133274. [PMID: 35805045 PMCID: PMC9265300 DOI: 10.3390/cancers14133274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/13/2022] [Accepted: 06/27/2022] [Indexed: 12/10/2022] Open
Abstract
Simple Summary Viral mutations at the preS region of hepatitis B virus (HBV) significantly increase the risk of developing hepatocellular carcinoma (HCC). Compared to HBV preS deletion, the oncogenic effect of preS combo mutation has rarely been investigated. With a cohort including 2114 subjects, we demonstrated that preS combo mutations G2950A/G2951A/A2962G/C2964A and C3116T/T31C significantly increased the risk of HCC in patients without antiviral treatment, whereas preS2 deletion significantly increased the risk of HCC in patients with antiviral treatment. The prevalence of C3116T/T31C (43.61%) was higher than preS2 deletion (7.16%). By using Sleeping Beauty mouse models and in vitro experiments, we found G2950A/G2951A/A2962G/C2964A, C3116T/T31C, and preS2 deletion promoted hepatocarcinogenesis by increasing levels of inflammatory cytokines, activating STAT3 pathway, enhancing endoplasmic reticulum stress, and altering gene expression profiles in inflammation- and metabolism-related pathways. These results suggest that preS combo mutations G2950A/G2951A/A2962G/C2964A and C3116T/T31C had similar oncogenic effects of preS2 deletion and should also be monitored. Abstract This study aimed to elucidate the effects and underlying mechanisms of hepatitis B virus (HBV) preS mutations on hepatocarcinogenesis. The effect of the preS mutations on hepatocellular carcinoma (HCC) occurrence was evaluated using a prospective cohort study with 2114 HBV-infected patients, of whom 612 received antiviral treatments. The oncogenic functions of HBV preS mutations were investigated using cancer cell lines and Sleeping Beauty (SB) mouse models. RNA-sequencing and microarray were applied to identify key molecules involved in the mutant-induced carcinogenesis. Combo mutations G2950A/G2951A/A2962G/C2964A and C3116T/T31C significantly increased HCC risk in patients without antiviral treatment, whereas the preS2 deletion significantly increased HCC risk in patients with antiviral treatment. In SB mice, the preS1/preS2/S mutants induced a higher rate of tumor and higher serum levels of inflammatory cytokines than did wild-type counterpart. The preS1/preS2/S mutants induced altered gene expression profiles in the inflammation- and metabolism-related pathways, activated pathways of endoplasmic reticulum (ER) stress, affected the response to hypoxia, and upregulated the protein level of STAT3. Inhibiting the STAT3 pathway attenuated the effects of the preS1/preS2/S mutants on cell proliferation. G2950A/G2951A/A2962G/C2964A, C3116T/T31C, and preS2 deletion promote hepatocarcinogenesis via inducing ER stress, metabolism alteration, and STAT3 pathways, which might be translated into HCC prophylaxis.
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Affiliation(s)
- Wenbin Liu
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China; (W.L.); (S.C.); (R.P.); (Z.L.); (X.Z.); (J.Y.); (X.C.); (L.C.); (X.T.)
| | - Shiliang Cai
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China; (W.L.); (S.C.); (R.P.); (Z.L.); (X.Z.); (J.Y.); (X.C.); (L.C.); (X.T.)
| | - Rui Pu
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China; (W.L.); (S.C.); (R.P.); (Z.L.); (X.Z.); (J.Y.); (X.C.); (L.C.); (X.T.)
| | - Zixiong Li
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China; (W.L.); (S.C.); (R.P.); (Z.L.); (X.Z.); (J.Y.); (X.C.); (L.C.); (X.T.)
| | - Donghong Liu
- Department of Liver Cancer Surgery, Third Affiliated Hospital, Second Military Medical University, Shanghai 200433, China;
| | - Xinyu Zhou
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China; (W.L.); (S.C.); (R.P.); (Z.L.); (X.Z.); (J.Y.); (X.C.); (L.C.); (X.T.)
| | - Jianhua Yin
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China; (W.L.); (S.C.); (R.P.); (Z.L.); (X.Z.); (J.Y.); (X.C.); (L.C.); (X.T.)
| | - Xi Chen
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China; (W.L.); (S.C.); (R.P.); (Z.L.); (X.Z.); (J.Y.); (X.C.); (L.C.); (X.T.)
| | - Liping Chen
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China; (W.L.); (S.C.); (R.P.); (Z.L.); (X.Z.); (J.Y.); (X.C.); (L.C.); (X.T.)
| | - Jianfeng Wu
- Department of Pathology, Xijing Hospital, Xi’an 710032, China;
| | - Xiaojie Tan
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China; (W.L.); (S.C.); (R.P.); (Z.L.); (X.Z.); (J.Y.); (X.C.); (L.C.); (X.T.)
| | - Xin Wang
- Laboratory of Molecular Cell Biology, Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, Shanghai 200433, China;
| | - Guangwen Cao
- Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China; (W.L.); (S.C.); (R.P.); (Z.L.); (X.Z.); (J.Y.); (X.C.); (L.C.); (X.T.)
- Correspondence: ; Tel.: +86-21-8187-1060
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Lin J, Zhang H, Yu H, Bi X, Zhang W, Yin J, Zhao P, Liang X, Qu C, Wang M, Hu M, Liu K, Wang Y, Zhou Z, Wang J, Tan X, Liu W, Shao Z, Cai J, Tang W, Cao G. Epidemiological Characteristics of Primary Liver Cancer in Mainland China From 2003 to 2020: A Representative Multicenter Study. Front Oncol 2022; 12:906778. [PMID: 35800051 PMCID: PMC9253580 DOI: 10.3389/fonc.2022.906778] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/11/2022] [Indexed: 01/27/2023] Open
Abstract
Background The contribution of hepatitis B virus (HBV) and hepatitis C virus (HCV) to primary liver cancer (PLC) and their association with cancer aggressiveness remains uncertain in China, a country with half of global PLC. We aimed to characterize this using data from four representative medical centers. Methods In total, 15,801 PLC patients were enrolled from the centers distributed in Easter5n, Southern, Northern, and Western China from 2003 to 2020. Of those, 7585 with curative surgery were involved in survival analysis. A nomogram was constructed using preoperative parameters to predict postoperative survival. Results Hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma, and combined hepatocellular cholangiocarcinoma accounted for 93.0%, 4.3%, and 1.6% in PLC, respectively. The seropositivities of HBV and HCV were 84.4% and 3.2% in HCC, respectively. The seropositivity of anti-HCV antibody was significantly higher in HBV-negative than in HBV-positive HCC patients (13.2% vs. 1.1%). Compared to HCV-positive HCC (HCV-HCC), HBV-positive HCC (HBV-HCC) was associated with 12-year earlier onset, higher proportions of males, high α-fetoprotein, large tumor size, advanced Barcelona Clinic Liver Cancer (BCLC) stage, and vascular tumor thrombus. The proportions of HCC and HBV seropositivity increased, whereas that of anti-HCV decreased, from 2003 to 2020. Postoperative five-year survival rate was 73.5%, 64.1%, 34.9%, and 19.7% in HCC at BCLC stage 0, A, B, and C, respectively. The multivariate Cox regression analysis showed that HBV seropositivity, incomplete tumor capsule, vascular tumor thrombus, tumor diameter (≥3 cm), advanced BCLC stage (B+C), α-fetoprotein (≥20ng/ml), and direct bilirubin (>8µmol/L) contributed independently to shorter overall survival (OS); whereas post-operative radiofrequency ablation and second resection independently improved OS in HCC. HCV-HCC had a more favorable prognosis than did HBV-HCC (Log-rank test, P<0.001). A nomogram composed of age, gender, and the preoperative independent risk factors was accurate in predicting postoperative survival in HCC (C-index: 0.735; 95% confidence interval: 0.727–0.743). Conclusion HBV contributes to 84.4% of HCC in China, and actively promotes hepatocarcinogenesis and HCC progression. A favorable postoperative survival obtained in patients at the early BCLC stage highlights the importance of screening for early HCC in high-risk populations. Our preoperative prognosis prediction model is important in clinical decision-making.
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Affiliation(s)
- Jiansheng Lin
- Department of Epidemiology, Second Military Medical University, Shanghai, China
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Hongwei Zhang
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Hongping Yu
- Department of Research, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Xinyu Bi
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weilu Zhang
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, China
| | - Jianhua Yin
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Pei Zhao
- Department of Research, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Xiumei Liang
- Office for Disease Process Management, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Chunfeng Qu
- State Key Lab of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Minjie Wang
- Department of Clinical Laboratory, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ming Hu
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Kun Liu
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, China
| | - Yuting Wang
- State Key Lab of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zihan Zhou
- Guangxi Office for Cancer Prevention and Control, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Junqi Wang
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Xiaojie Tan
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Wenbin Liu
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Zhongjun Shao
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, China
- *Correspondence: Zhongjun Shao, ; Jianqiang Cai, ; Weizhong Tang, ; Guangwen Cao,
| | - Jianqiang Cai
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Zhongjun Shao, ; Jianqiang Cai, ; Weizhong Tang, ; Guangwen Cao,
| | - Weizhong Tang
- Department of Gastrointestinal Surgery and Guangxi Clinical Research Center for Colorectal Cancer, Guangxi Medical University Cancer Hospital, Nanning, China
- *Correspondence: Zhongjun Shao, ; Jianqiang Cai, ; Weizhong Tang, ; Guangwen Cao,
| | - Guangwen Cao
- Department of Epidemiology, Second Military Medical University, Shanghai, China
- *Correspondence: Zhongjun Shao, ; Jianqiang Cai, ; Weizhong Tang, ; Guangwen Cao,
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