Effect of hepatitis B virus infection status on liver metastasis of nasopharyngeal carcinoma: a cohort study

Abstract

Background The impact of hepatitis B virus (HBV) infection status on liver metastasis of nasopharyngeal carcinoma (NPC) has not been thoroughly elucidated to date. This study aimed to determine how HBV infection status influences liver metastasis of NPC through the analysis of clinical samples. Methods A total of 1,367 patients with pathologically diagnosed NPC who received systemic treatment at Nanfang Hospital or Zhujiang Hospital between January 2005 and December 2015 were enrolled in this retrospective study. Based on their HBV infection status, these patients were separated into four groups: negative infection (n=492), chronic HBV infection (n=123), inactive HBV carrier (n=175), and resolved HBV infection (n=577). The relationship between HBV infection status and liver metastasis of NPC was examined. Results Compared with the negative infection group, we observed that an inactive HBV carrier status was related to liver metastasis in patients with NPC (HR: 0.392; 95% CI: 0.178–0.863; P=0.020). The resolved HBV infection group had a lower risk of liver metastasis than the negative infection group (HR: 0.621; 95% CI: 0.402–0.959; P=0.032). There was no direct association between HBV infection status and distant metastasis of NPC. Conclusions Inactive HBV infections and resolved HBV infections are highly associated with a decreased risk of liver metastases in NPC patients compared with patients without HBV infections.

The Effect of Diffuse Liver Diseases on the Occurrence of Liver Metastases in Cancer Patients: A Systematic Review and Meta-Analysis

“…Nineteen studies met the inclusion criteria and were included in synthesis, for a total of 37,591 patients: 6868 exposed and 29,992 non-exposed ( Table 1 ). Among the 19 included studies [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ], five reported overall survival [ 23 , 24 , 31 , 33 , 34 ]. The majority of the selected studies focused on liver metastases from colorectal cancer, while four focused on other cancers.…”

“…As for the comparability domain, the major concern was the lack of homogeneity between exposed and non-exposed patients in terms of major confounders, this being truer for hospital-based rather than population-based studies. However, among the included studies on metachronous liver metastases, eight presented adjusted analysis (Chiou 2014 [ 20 ], Hamady 2012 [ 23 ], Murono 2013 [ 26 ], Qian 2014 [ 31 ], Kondo 2016 [ 34 ], Wu 2017 [ 35 ], Wu 2019 [ 36 ], Li 2019 [ 38 ]) one did not use adjustments but included analysis on matched patients (Ramos 2015 [ 24 ]) and only two (Zeng 2013 [ 33 ] and Li Destri 2013 [ 30 ]) did not provide adjusted hazard ratios. Among confounders included into the adjusted analyses, age, sex, T and N staging components were always present, although two studies did not provide clear indications of considered confounders (Qian 2014 [ 31 ] and Chiou 2014 [ 20 ]).…”

“…Liver steatosis can be diagnosed either by imaging techniques or by pathological examination, while for viral hepatitis, some studies included only active disease and others included any serological signs of present or past infection. Only one study (Li 2019 [ 38 ]) stratified for different types of viral infection status, suggesting that inactive or resolved infection but not chronic infection had a protective effect on liver metastasis occurrence. Hence, this inconsistency in exposure definitions is probably one of the main sources of residual heterogeneity.…”

“…I2 is reported as a measure of heterogeneity. Overall RR and I2 were calculated after excluding the comparison between patients with and without steatosis for Li 2019 [ 38 ] since this was a secondary outcome in the study.…”