代谢综合征与乙型肝炎病毒相关肝细胞癌术后肝纤维化程度及预后的关联分析OA

Objective To investigate the association between metabolic syndrome(MetS)hepatic fibrosis progression and long-term outcomes in patients with hepatitis B virus(HBV)-related hepatocellular carcinoma(HCC)after repeated hepatectomy.Methods A total of 138 patients with HBV-related HCC who underwent two hepatectomies between July 1,2015,and March 31,2024 at Guangxi Medical University Cancer Hospital were included.Patients were divided into MetS(n=12)and non-MetS groups(n=126)according to the presence of MetS.Hepatic fibrosis was assessed using the Ishak and Scheuer scoring systems.Inflammatory activity was assessed using the Ishak-HAI score,and fibrosis changes were categorized as progression,stability,or regression.Overall survival(OS)and recurrence-free survival(RFS)were compared between the two groups.Results The MetS group had higher proportions of obesity,diabetes,hypertension,low high-density lipoprotein cholesterolemia levels,and hypertriglyceridemia,but a lower proportion of patients with elevated preoperative aspartate amino-transferase(AST)levels.In both groups,inflammation and fibrosis tended to decrease in the second resection specimens,with significant reductions in Ishak-HAI scores(P=0.043)and Scheuer scores(P<0.001)in the non-MetS group.Changes in Ishak fibrosis scores did not differ significantly between the MetS and non-MetS groups in terms of fibrosis progression,regression,or stability(P=0.562).Similarly,changes in Scheuer scores showed no significant differences(P=0.752).MetS was not significantly associated with OS(HR=1.049,P=0.937)or RFS(HR=1.290,P=0.493).Conclusions In patients with HBV-related HCC undergoing repeated hepatectomy,MetS was not significantly associated with changes in hepatic fibrosis between resections or long-term OS or RFS.