Effects of hepatitis B virus infection and antiviral therapy on the clinical prognosis of nasopharyngeal carcinoma

• Published in: Cancer medicine (Malden, MA) MA), 2020-01, Vol.9 (2), p.541-551
• Main Authors: Weng, Jing‐Jin, Wei, Jia‐Zhang, Li, Min, Lu, Jin‐Long, Qin, Yang‐Da, Jiang, He, Qu, Shen‐Hong
• Format: Article
• Language: English
• Subjects: Antibodies; Antigens; Antiviral agents; Antiviral Agents - therapeutic use; Antiviral drugs; antiviral therapy; Blood; Cancer therapies; CD4 antigen; Chemotherapy; Clinical Cancer Research; Deoxyribonucleic acid; DNA; Female; Follow-Up Studies; Genetic testing; Hepatitis; Hepatitis B; Hepatitis B - complications; Hepatitis B - drug therapy; Hepatitis B - virology; Hepatitis B surface antigen; hepatitis B virus; Hepatitis B virus - drug effects; Hepatitis B virus - isolation & purification; Humans; Infections; Injuries; Liver; Lymphocytes T; Male; Medical prognosis; Medical records; Metastases; Metastasis; Middle Aged; Multivariate analysis; Nasopharyngeal carcinoma; Nasopharyngeal Carcinoma - epidemiology; Nasopharyngeal Carcinoma - mortality; Nasopharyngeal Carcinoma - virology; Nasopharyngeal Neoplasms - epidemiology; Nasopharyngeal Neoplasms - mortality; Nasopharyngeal Neoplasms - virology; Original Research; Patients; Prognosis; Radiation therapy; Retrospective Studies; Risk factors; Statistical analysis; Studies; Survival analysis; Survival Rate; Throat cancer
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.2715

Purpose To investigate the clinical characteristics of nasopharyngeal carcinoma (NPC) and a concomitant hepatitis B virus (HBV) infection, as well as the potential effects of HBV infection and antiviral therapy on prognosis. Methods We conducted a retrospective chart review of all NPC patients from December 2010 to December 2014. After collecting medical records and conducting follow‐ups on patients, a total of 876 eligible NPC patients were included. For each patient, medical records were reviewed. Factors predictive of outcome were compared using the log‐rank test and Cox regression analysis. Results Among the 876 participants, 106 (12.1%) patients were HBV‐infected patients. The hepatitis B surface antigen‐positive [HBsAg(+)] group had a lower CD4+ T cell count than the HBsAg(−) group (P = .048). Among patients with stage I/II NPC, 5‐year overall survival (OS), disease‐free survival (DFS), relapse‐free survival, and distant metastasis‐free survival (DMFS) of the HBsAg(+) group were 82.5%, 70.7%, 87.7%, and 76.6%, respectively, whereas those of the HBsAg(−) group were 91.4%, 86.0%, 93.8%, and 92.1%, respectively. Statistically significant differences in OS, DFS, and DMFS existed between both groups (P = .017, .018, and .004, respectively). The multivariate analysis indicated that HBsAg status and N stage are independent risk factors affecting OS, DFS, and DMFS of NPC patients. A statistically significant difference in 5‐year DMFS existed between the antivirus (90.0%) and no‐antivirus groups (70.0%) (P = .043). Conclusions Hepatitis B virus infection is an independent risk factor for early stage NPC, which may be associated with its reduced immune functions compared to the HBsAg(−) group. Anti‐HBV treatment may improve the prognosis of HBV‐infected NPC patients. Nasopharyngeal carcinoma (NPC) is a unique head and neck cancer with a high incidence in southern China, and this area has a higher hepatitis B virus (HBV) infection rate than other regions. Hepatitis B virus infection is an independent risk factor for early‐stage NPC, which may be associated with its reduced immune functions compared to the HBsAg(−) group. Anti‐HBV treatment may improve the prognosis of HBV‐infected NPC patients.