Hepatitis B virus infection specially increases risk of liver metastasis in breast cancer patients: a propensity-matched analysis

Abstract

Background: Breast cancer and hepatitis B virus (HBV) infection are serious public health issues in China.But the effect of HBV infection on breast cancer remains unclear. The objective was to assess whether HBV infection was associated with prognosis of breast cancer.Methods: A retrospective database of 1,924 invasive breast cancer patients from Sun Yat-sen University Cancer Center from 2008 to 2010 was established. Propensity score matching method was applied to balance baseline parameters. Logistic regression was used for identifying the independent risk factors of liver metastasis. Prognostic outcomes were evaluated via Kaplan-Meier analysis and Cox model.Results: Primary evaluation of gross data suggested HBV infection was associated with much higher rate of liver metastasis. 642 patients were matched for analysis. The median follow-up time was about 69 months.Patients with HBV surface antigen (HBsAg) (+) had a specially higher risk of liver metastasis aside of other distant organs than those with HBsAg (−). HBsAg (−/+) was identified to be an independent risk factor of liver metastasis [odds ratio (OR), 2.651; 95% confidence intervals (CI), 1.213-5.796; P=0.015]. HBsAg (+) was associated with liver metastasis significantly in stage III or in estrogen receptor (ER) (+) and/or progesterone receptor (PR) (+), human epidermal growth factor receptor-2 (HER-2) (−) subtype. Meanwhile, patients with HBsAg (+) had significant shorter liver metastasis-free survival (LMFS) compared with HBsAg (−) patients (P=0.041). But the difference of overall survival (OS) between the HBsAg (−) and HBsAg (+) groups reached statistically no significance (P=0.425).The multivariate analysis suggested HBsAg (+) could worsen the outcome of LMFS [hazards ratio (HR), 2.450; 95% CI, 1.169-5.135; P=0.018]. Conclusions:In breast cancer, HBsAg (+) was associated with specially a higher rate of liver metastasis and thus worsened the LMFS. HBsAg (−/+) was an independent risk factor of liver metastasis.

The global status of research in breast cancer liver metastasis: a bibliometric and visualized analysis

“…According to the overlay visualization map( Figure 5(b )), Tang, HL is the author who is most interested in BCLM recently, mainly prognostic factors of different modes of metastasis in breast cancer using population-based study exploring [ 28 ]. And it’s reported that patients with HBsAg(+) had a higher incidence of liver metastasis in breast cancer [ 29 ]. Moreover, the academic community consisting of Sun Jiayuan, He Zhenyu and Wang Sangang, et al, kept the research on BCLM in full swing.…”

[Retracted] Expression Levels and Clinical Significance of Serum miR‐497, CEA, CA24‐2, and HBsAg in Patients with Colorectal Cancer

“…Hepatitis B surface antigen (HBsAg) is also useful in detecting liver metastases of malignant and cancerous tumors [ 22 ]. The HBsAg level of patients with liver metastases is greatly lower than that of patients without liver metastases [ 23 ]. The early diagnosis and the judgment of lymph node metastasis or liver metastasis are vital in the diagnosis and treatment evaluation of CRC.…”

HBV Infection Status Does Not Influence the Initial Metastatic Pattern and the Prognosis of Breast Cancer Patients with de novo and Relapsed Metastatic Disease

“…However, HBV infection was not associated with extrahepatic metastases. 48 On the contrary, Xiao et al found that HBV infection did not independently affect HMFS of patients with non-metastatic breast cancer. 16 Li et al reported that, for very young patients with curatively resected breast cancer, HBsAg did not increase the rate of liver metastases.…”

“… 43 Xiao et al demonstrated that chronic HBV infection predicts a worse prognosis in stage II/III BC patients, but not stage I BC. 16 However, Gao et al 52 and Yu et al 48 respectively found that HBV infection had no association with DFS and OS of breast cancer patients. In the present study, we found that HBV infection did not influence the survival of MBC, no matter in patients with de novo or relapsed metastatic disease.…”