Hepatitis B core antibody (HBcAb)-positive is significantly correlated with hilar cholangiocarcinoma and affects operative safety of major hepatectomy in Chinese patients

Abstract

Background: Hepatitis B virus (HBV) may be a risk factor for cholangiocarcinoma, but it is not yet clear that the relationship between hepatitis B core antibody (HBcAb)-positive and hilar cholangiocarcinoma (hCCA). In addition, we evaluated the impact of HBcAb-positive on the safety of major hepatectomy for hCCA. Methods：A retrospective analysis was performed on the status of hepatitis B infection, liver fibrosis, surgical safety, and long-term postoperative survival of 111 patients who underwent major hepatectomy in Tongji Hospital from April 2012 to September 2019.Results: HBsAg-positive was identified in 10.6%, HBcAb-positive was found in 73.7% of the patients. A high-grade of liver fibrosis was detected in 67.9% of the patients with HBcAb-positive, which was markedly higher than that in the patients with HBcAb-negative (43.3%) (P=0.018). The incidence rates of postoperative complications and 30-day mortality were 38.7% (43/111) and 5.4% (6/111), respectively. Multivariate analysis showed that the independent risk factors for complications were HBcAb, vascular reconstruction, lymphadenectomy, HBcAb-positive correlated with a higher incidence of complications after major hepatectomy for hCCA (adjusted hazard ratio [HR] 3.984, 95%CI 1.354-11.73; P = 0.012). All the patients who died within 30-day after surgery were HBcAb-positive. However, there was no correlation between HBcAb and long-term prognosis of major hepatectomy for hCCA.Conclusions: HBcAb-positive is closely correlated with hCCA. HBcAb-positive markedly increased the incidence of postoperative complications and mortality of major hepatectomy for hCCA.