<p>Serum hepatitis B viral (HBV) DNA is a predictive biomarker for survival in non-small cell lung cancer patients with chronic HBV infection</p>

Abstract

Purpose: To study the association between pretreatment serum hepatitis B viral (HBV) DNA copy numbers and clinical outcome of non-small cell lung cancer (NSCLC) patients with chronic HBV infection. Patients and methods: We retrospectively evaluated the medical records of NSCLC HBV (+) patients between January 2008 and December 2010. The HBV DNA copy numbers and other prognostic factors including albumin (ALB), C-reactive protein (CRP), platelet, neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and Glasgow Prognostic Score (GPS) were obtained before any antitumor treatment. Kaplan–Meier curves and the log-rank test were used to calculate prognostic significance. A multivariable Cox proportional hazard regression was modeled to analyze the independent prognostic factors for NSCLC HBV (+) patients. All independent prognostic factors in the Cox multivariable analysis were used to build a nomogram. The predictive accuracy of HBV DNA, TNM stage and nomogram was evaluated with the concordance index (C-index) and time-dependent receiver operating characteristics (ROC) curves, and simultaneously compared with traditional TNM staging system respectively. Results: A total of 188 patients were recruited in this study; the median age was 56 years, and the median overall survival (OS) was 34 months. Cox multivariate analysis results showed independent factors for OS including TNM stage ( P =0.028), treatment ( P =0.002), HBV DNA ( P <0.001), and GPS ( P =0.026). The nomogram model for survival was built based on four prognostic factors. The C-index for HBV DNA was 0.67, 0.69 for TNM stage, and 0.76 for the nomogram model. There was no statistical difference between HBV DNA and TNM stage ( P =0.48). However, the C-index values of nomogram model were statistically higher both than HBV DNA (0.76 vs 0.67, P <0.001), and TNM stage (0.76 vs 0.69, P <0.001). Conclusion: Pretreatment serum HBV DNA copy numbers can act as a prognostic marker of survival for NSCLC patients with chronic HBV infection.

Comorbidities and mortality risk among extensive-stage small-cell lung cancer patients in mainland China: impacts of hypertension, type 2 diabetes mellitus, and chronic hepatitis B virus infection

“…In a similar study, Fu et al [50] reported that high pretreatment serum HBV DNA copy numbers could act as a negative prognostic marker for survival among NSCLC patients with chronic HBV infection. Conversely, Zou et al [51] found that among esophageal cancer patients, those who were HBsAg-positive had a more favorable OS (HR, 0.80; 95% CI, 0.65-0.95; P = 0.020) than those who were HBsAg-negative.…”

“…In a similar study, Fu et al . [ 50 ] reported that high pretreatment serum HBV DNA copy numbers could act as a negative prognostic marker for survival among NSCLC patients with chronic HBV infection. Conversely, Zou et al .…”

Hepatitis B virus infection: An insight into the clinical connection and molecular interaction between hepatitis B virus and host extrahepatic cancer risk

“…More recently, epidemiological evidence demonstrated a potential association between HBV infection and extrahepatic cancer risk, which includes gastrointestinal cancers, head and neck cancer, cervical cancer, non-Hodgkin lymphoma, breast cancer, and nonsmall cell lung cancer (NSCLC) (13,14,(35)(36)(37)(38)(39) (Figure 1). Notably, HBV infection status can not only increase the extrahepatic cancer risk but can also significantly influence subsequent long-term survival patterns (40)(41)(42)(43)(44)(45). However, a multi-center study demonstrated that a large proportion of patients with newly diagnosed cancer and concurrent HBV were unaware of their viral infection at the time of cancer diagnosis (46).…”

“…Combining HBV infection status with peripheral blood indicators, clinicians could obtain more precise survival predictions in this subpopulation. Serum HBV DNA levels could also be an independent prognostic factor in patients with NSCLC (41). HBV infection was recently associated with NSCLC immune expression (112,113).…”