Association Between Hepatitis B Virus and Pancreatic Cancer

Abstract

Purpose Hepatitis B virus (HBV) and hepatitis C virus (HCV) are considered to be hepatotropic and are a major cause of hepatocellular carcinoma. However, little is known about the role of HBV and HCV infection in other malignancies. This study aimed to determine whether HBV and HCV infection increase the risk for pancreatic cancer development. Patients and Methods At The University of Texas M.D. Anderson Cancer Center, Houston, we recruited 476 patients with pathologically confirmed adenocarcinoma of the pancreas and 879 age-, sex-, and race-matched healthy controls. Blood samples were tested for the presence of HCV antibodies (anti-HCV), HBV surface antigen (HBsAg), antibodies against HBV core antigen (anti-HBc), and antibodies against HBsAg (anti-HBs). The positive samples were retested by two confirmatory tests. An unconditional multivariable logistic regression analysis was used to estimate adjusted odds ratios (AORs). Results Anti-HCV was positive in 7 cases (1.5%) and 9 controls (1%). Anti-HBc was positive in 36 cases (7.6%) and 28 controls (3.2%). The estimated AORs and 95% confidence intervals (CIs) were as follows: anti-HCV+, 0.9 (0.3–2.8), anti-HBc+, 2.5 (1.5–4.2), anti-HBc+/anti-HBs+, 2.3 (1.2–4.2), and anti-HBc+/anti-HBs-, 4 (1.4–11.1). Risk modification by past exposure to HBV was observed among diabetics (AOR, 7.1; 95% CI, 1.7–28.7). Conclusion Past exposure to HBV may be associated with pancreatic cancer development. Should such findings be confirmed by other studies, it may offer important insights on the etiology of the pancreatic cancer and may suggest the need to consider prevention of HBV reactivation among HBV-related pancreatic cancer patients during chemotherapy treatment.

Chronic Hepatitis B Virus Infection and Risk of Pancreatic Cancer: A Meta-analysis

“…After review, two studies were excluded with the following reasons: a study of HCV infection (El-Serag et al, 2009); a case report (Yoo et al, 2009). Thus, eight articles met the inclusion criteria (de Gonzalez et al, 2008;Hassan et al, 2008;Gordon et al, 2009;Iloeje et al, 2009;Hong et al, 2010;Zhu et al, 2011;Ben et al, 2012;Wang et al, 2012), six of these studies were conducted only in East Asia (de Gonzalez et al, 2008;Iloeje et al, 2009;Hong et al, 2010;Zhu et al, 2011;Ben et al, 2012;Wang et al, 2012) and two in USA (Hassan et al, 2008;Gordon et al, 2009).…”

“…There were a total of 302420 individuals in the included eight studies. In most of the studies (de Gonzalez et al, 2008;Hassan et al, 2008;Gordon et al, 2009;Zhu et al, 2011;Ben et al, 2012;Wang et al, 2012), pancreatic cancer was diagnosed according the histology. In other studies (Iloeje et al, 2009;Hong et al, 2010), pancreatic cancer is confirmed by histology or diagnosed by symptoms, signs and more than two types of imaging tools.…”

“…Of these eight studies, five were conducted in a hospital-based case-control study design (Hassan et al, 2008;Hong et al, 2010;Zhu et al, 2011;Ben et al, 2012;Wang et al, 2012), three in cohort design (de Gonzalez et al, 2008;Gordon et al, 2009;Iloeje et al, 2009 al., 2012), two in USA (Hassan et al, 2008;Gordon et al, 2009). The selection of controls varied substantially.…”

“…The selection of controls varied substantially. Controls were acute patients (Hassan et al, 2008;Hong et al, 2010;Zhu et al, 2011;Ben et al, 2012;Wang et al, 2012), patients with active HBV infection (Gordon et al, 2009), or volunteers for checkup (de Gonzalez et al, 2008;Gordon et al, 2009;Iloeje et al, 2009). All groups of controls appeared to be selected on the basis of convenience.…”

“…Also, some cohort and case-control studies (de Gonzalez et al, Lei Li 1,3 , Bo Wu 2 , Li-Bo Yang 3 , Guan-Cheng Yin 3 , Ji-Yong Liu 1 * 2008; Hassan et al, 2008;Iloeje et al, 2009;Gordon et al, 2009;Hong et al, 2010;Zhu et al, 2011;Wang et al, 2012;Ben et al, 2012) have been conducted to estimate the relationship between chronic hepatitis B virus infection and pancreatic cancer. But the results were controversial.…”