Abstract:
The association between Hepatitis B virus (HBV) infection and colorectal liver metastases (CRLM) remains ambiguous in current population-based evidence. To clarify this, we present a retrospective analysis of 5871 colorectal cancer (CRC) patients. Propensity score matching (PSM) was applied to harmonize age and sex disparities within HBV+ (n = 1696) and HBV- (n = 4175) groups and further within HBV+ subgroups of chronic (CHB, n = 474) and occult (OHB, n = 1222) infections. Our initial results indicated a significant association between HBV infection and synchronous colorectal liver metastasis (SYN-CRLM); however, this association dissipated after PSM was employed to adjust for confounding variables. No significant association was observed between HBV infection and metachronous colorectal liver metastases (MET-CRLM) both before and after PSM. Further analysis revealed that HBV replication status did not influence the incidence of CRLM. However, HBV+ participants demonstrated an increased incidence of metachronous extrahepatic metastases, particularly to the lungs. Our findings imply that neither past nor present HBV infection is significantly correlated with the occurrence of SYN-CRLM or MET-CRLM. The absence of an association between HBV replication status and CRLM incidence highlights the importance of incorporating a broader range of factors in the clinical management of CRLM beyond the status of HBV infection.
摘要:
乙型肝炎病毒(HBV)感染与结直肠癌肝转移(CRLM)之间的关联在当前基于人群的证据中仍然模棱两可。为了澄清这一点,我们对5871例结直肠癌(CRC)患者进行了回顾性分析.倾向评分匹配(PSM)用于协调HBV+(n=1696)和HBV-(n=4175)组中的年龄和性别差异,并进一步在HBV+慢性亚组(CHB,n=474)和隐匿性(OHB,n=1222)感染。我们的初步结果表明HBV感染和同步结直肠肝转移(SYN-CRLM)之间的显着关联;然而,这种关联在PSM用于校正混杂变量后消失.在PSM之前和之后,HBV感染与异时性结直肠癌肝转移(MET-CRLM)之间均未观察到显着关联。进一步分析表明,HBV复制状态不影响CRLM的发生率。然而,HBV+参与者表现出异时肝外转移的发生率增加,尤其是肺部。我们的发现暗示,无论是过去还是现在的HBV感染都与SYN-CRLM或MET-CRLM的发生显着相关。HBV复制状态与CRLM发病率之间没有关联,突出了在HBV感染状态之外的CRLM临床管理中纳入更广泛因素的重要性。