Independent risk factors for disease recurrence after surgery in patients with hepatitis B virus-related hepatocellular carcinoma≤3 cm in diameter

Background:Post-operative recurrence rates are high for hepatitis B virus(HBV)-related hepatocellular carcinoma(HCC).This study aimed to explore the factors associated with post-operative 1-year recurrence rate in patients with HBV-related HCC who had a single small primary tumor(3 cmin diameter).Methods:This was a retrospective study of 203(training cohort)and 64(validation cohort)patients newly diagnosed with HBV-related HCC who had a single small primary tumor.The first year of post-operative follow-up was examined.Factors potentially associated with HCC recurrence were identified using Cox regression analyses.A model was constructed based on the factors identified and the prognostic value of the model was evaluated using receiver operating characteristic(ROC)curve analysis and calculation of the area under the ROC curve(AUC).Results:A history of alcoholismand serum levels of a-fetoprotein,total protein and c-glutamyl transpeptidase(GGT)were independently associated with 1-year recurrence rate after surgery.A predictive model based on these four factors had an AUC of 0.711(95%confidence interval,0.643–0.772)in the training cohort and 0.727(95%confidence interval,0.601–0.831)in the validation cohort.The 1-year recurrence rate was significantly lower in the low-risk group than in the high-risk group in both the training cohort(17.0%vs.49.5%,P<0.001)and the validation cohort(43.2%vs.74.1%,P=0.031).Conclusion:A history of alcoholism and serum levels of a-fetoprotein,total protein and c-glutamyl transpeptidase were independently associated with post-operative 1-year recurrence rate in patients with HBV-related HCC who had a single small primary tumor(3 cmin diameter).

Telomerase reverse transcriptase promoter mutations in hepatocellular carcinogenesis

Through several studies exploiting next-generation sequencing,we are obtaining a clearer picture of the complex genetic and molecular landscape of hepatocellular carcinoma(HCC).Consistent with the findings of other cancer types,telomerase reverse transcriptase(TERT)promoter mutations have been frequently reported in HCC.C228T and C250T are two major types of hot spot mutations in the TERT promoter region.Besides,in hepatitis B virus(HBV)-related HCC cases,the TERT promoter is recurrently interrupted by integration of HBV DNA.TERT promoter mutations are thought to be an early event in HCC carcinogenesis,and they are significantly associated with disease progression.In this review,we provide an updated overview of the somatic mutations in the TERT promoter region and discuss their possible roles in the development of HCC.