The status of compensated cirrhosis might be negatively associated with the tumor size in patients with hepatitis B virus-related hepatocellular carcinoma

Yanna Liu^1†, Xiangjun Qian^2†, Congying Wu³, Weidong Pan², Jingmin Zhao⁴, Xiangmei Chen^1*, Fengmin Lu^1,5*

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¹ Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Peking University, Beijing 100191, China

² Department of Pancreatic-Hepatobiliary Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China

³ Institute of Systems Biomedicine, Beijing Key Laboratory of Tumor Systems Biology, School of Basic Medical Sciences, Peking University Health Science Center, Peking University, Beijing 100191, China

⁴ Department of Pathology and Hepatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China

⁵ Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China

Global Translational Medicine 2022, 1(2), 94 https://doi.org/10.36922/gtm.v1i2.94

Submitted: 12 May 2022 | Accepted: 22 July 2022 | Published: 12 August 2022

© 2022 by the Authors. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

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Abstract

Liver cirrhosis has been a well-known risk factor for the development of hepatocellular carcinoma (HCC). However, this view has recently been challenged. This study aimed to investigate the potential association of cirrhosis with hepatitis B virus (HBV)-related HCC. In this study, two independent multicenter clinical cohorts that included 1,431 HCC patients with chronic HBV infection were retrospectively studied. The first cohort consisted of 334 HCC patients undergoing curative resection and cirrhosis, who have been pathologically diagnosed. The second cohort consisted of 1,087 HCC patients, who have been diagnosed for the presence of cirrhosis based on clinical evidence. Patients of each cohort were further divided into different subgroups according to the presence of cirrhosis and the severity of the cirrhosis. In both cohorts, patients with cirrhosis had smaller tumor size compared to those without cirrhosis (P < 0.05) and a relatively lower proportion of large tumor, defined as tumor size > 5 cm in diameter (P < 0.05). Patients with decompensated cirrhosis had the highest rate of vascular invasion and/or extrahepatic metastases compared with compensated cirrhosis and non-cirrhosis (53.0% vs. 24.8% vs. 26.9%, P < 0.001). In the first cohort, globulin (odds ratio [OR] = 1.096, P = 0.001) and vascular invasion (OR = 4.013, P = 0.013) were independent risk predictors of HCC tumor size >5 cm, while cirrhosis stage Laennec 4B/C was a protective factor (OR = 0.372, P = 0.002). Similar results were observed in the second cohort. In conclusion, this study implied that HCC patients with compensated cirrhosis tend to harbor smaller tumor, but severe cirrhosis favors tumor vascular invasion and metastasis.

Keywords

Liver cirrhosis

Hepatocellular carcinoma

Hepatitis B virus

Neoplasm metastasis

Vascular invasion

Funding

National S and T Major Project for Infectious Diseases

National Natural Science Foundation of China

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Conflict of interest

The authors declared no conflict of interest related to this article.

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