The presence of HBV infection in extra-hepatic sites such as pancreas and other organs has been identified in multiple studies. HBV is a well-known oncogenic virus for hepatocellular carcinoma (HCC), which may also cause some extrahepatic malignancies or diseases, such as non-Hodgkin lymphoma, aplastic anemia and nephritis. Thus, there is a great likelihood that some PDAC patients are also HBsAg carriers or they once were subject to HBV exposure. Roughly 7.2% of the Chinese population are chronic HBsAg carriers and approximately 60% have been exposed to HBV infection. However, to date whether hepatitis B virus (HBV) infection could influence the prognosis in patients with advanced PDAC has not been well established and confirmed yet.Ĭhina is one of the countries boasting high endemicity of HBV infection. Mounting evidences have demonstrated that some clinical parameters may affect the survival of PDAC patients such as tumor stages, postoperative pathological findings and CA-199 level. Due to the limited options for patients with PDAC at locally advanced and metastatic stages, these patients with unresectable PDAC often have dismal prognosis. Due to the obscure symptoms at early stages and the aggressive progression of the disease, only around 15-20% of PDAC patients have a chance to receive radical surgery at diagnosis and most of the patients are detected the disease with unresectable advanced tumors. Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer deaths in the United States and the seventh leading cause of cancer deaths in China. Inactive carrier(IC) and resolved HBV infection showed no significant association with survival compared to non HBV infection.Ĭonclusion: 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. 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). 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. 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. The association between HBV status and advanced PDAC progression was then examined. 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. 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. Therefore, we conducted this study to assess the effect of HBV infection on PDAC progression among a large cohort in China. Purpose: Whether the progression of advanced pancreatic ductal adenocarcinoma (PDAC) patients could be affected by HBV exposure remains to be determined. Received: MaAccepted: JPublished: NovemAbstract * These authors have contributed equally to this study Qiwen Chen 1,2,*, Zhouyu Ning 1,*, Lei Wang 3,*, Haifeng Ying 4,*, Shu Dong 1,*, Chenyue Zhang 1,*, Xiaoheng Shen 4, Yuanbiao Guo 4, Hao Chen 1, Xiaoyan Zhu 1, Yehua Shen 1, Weidong Shi 1, Yongqiang Hua 1, Kun Wang 1, Junhua Lin 1, Litao Xu 1, Lianyu Chen 1, Lanyun Feng 1, Xiumei Zhang 1, Jing Xie 1, Bo Sun 5, Yaqin Sun 6, Wenchao Gu 6, Mei Kang 2, Zheng Tang 2, Zhujun Chen 7, Zhen Chen 1, Luming Liu 1, Jinming Yu 2, Zhaoshen Li 3 and Zhiqiang Meng 1ġ Department of Integrative Oncology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, ChinaĢ Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, Chinaģ Digestive Endoscopy Center, Department of Gastroenterology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, ChinaĤ Department of Integrative Medicine of Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, Chinaĥ Department of Endoscopy and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, ChinaĦ Department of Radiology and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, Chinaħ Department of Clinical Laboratory and Department of Oncology, Fudan University, Shanghai Cancer Center, Shanghai Medical College, Shanghai, China
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