行肝癌切除术的HBsAg阳性和HBsAg阴性/抗-HBc阳性原发性肝癌患者临床特点对比分析  

Clinical characteristics of patients with HBs Ag( + ) versus HBs Ag(-) / HBc Ab( + ) primary hepatic carcinoma treated by hepatectomy: a comparative analysis

作　　者：杨可立[1] 杨湛[1] 关玉娟[1] 应若素[1] 李剑萍[1] 

机构地区：[1]广州市第八人民医院肝病二科,广州510060

出　　处：《临床肝胆病杂志》2015年第6期907-909,共3页Journal of Clinical Hepatology

摘　　要：目的比较分析行肝癌切除术的HBs Ag阳性和HBs Ag阴性/抗-HBc阳性的原发性肝癌患者的临床特点差异。方法收集广州市第八人民医院2009年10月至2014年11月行肝癌切除术后的原发性肝癌患者61例,其中HBs Ag阳性患者43例,HBs Ag阴性/抗-HBc阳性患者18例,比较两组患者性别、年龄、肿瘤病理分化程度、脉管癌栓、肝硬化情况等临床特点。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验,非参资料组间比较采用Mann-Whitney U检验。结果 HBs Ag阳性组和HBs Ag阴性/抗-HBc阳性组发病年龄间差异无统计学意义[(50.77±12.93)岁vs(54.28±9.89)岁,t=-1.031,P>0.05];两组患者发现胆管细胞癌的比率差异无统计学意义(2.3%vs 16.7%,χ2=2.24,P>0.05);两组患者发现肝硬化的比率差异无统计学意义(62.8%vs 44.4%,χ2=1.746,P>0.05);两组间AFP水平比较,差异无统计学意义[(3638±7869)ng/ml vs(3577±9628)ng/ml,t=0.026,P>0.05];两组肿瘤病理分化程度差异无统计学意义(Z=-1.085,P>0.05);两组脉管癌栓比率差异亦无统计学意义(34.9%vs 22.2%,χ2=0.949,P>0.05)。结论行肝癌切除术的HBs Ag阴性/抗-HBc阳性的原发性肝癌患者其发病年龄及疾病的发展与HBs Ag阳性患者差异无统计学意义。由于隐匿性乙型肝炎感染的可能,HBs Ag阴转仍需监测肝癌的发生。Objective To explore the differences in clinical characteristics between patients with HBs Ag（ ＋） and HBs Ag（-） / HBc Ab（ ＋） primary hepatic carcinoma（ PHC） treated by hepatectomy. Methods Forty- three HBs Ag（ ＋） and 18 HBs Ag（-） /HBc Ab（ ＋）patients who underwent liver resection against PHC from October 2009 to November 2014 in Guangzhou 8th People＇s Hospital were selected for the study. The clinical data of the subjects,including sex,age,histological differentiation,intravascular tumor thrombi,and hepatic cirrhosis,were compared,using t test for continuous data,chi- square test for categorical data,and Mann- Whitney U test for non- parametric data. Results No significant differences existed between patients with HBs Ag（ ＋） and HBs Ag（-） / HBc Ab（ ＋） PHC in terms of the age of onset（ 50. 77 ± 12. 93 years vs 54. 28 ± 9. 89 years,t =- 1. 031,P〈0. 05）,the incidence of cholangiocarcinoma（ 2. 3% vs16. 7%,χ2= 2. 24,P〈0. 05）,the incidence of hepatic cirrhosis（ 62. 8% vs 44. 4%,χ2= 1. 746,P〈0. 05）,alpha- fetoprotein level（ 3638 ± 7869 ng/ml vs 3577 ± 9628 ng/ml,t = 0. 026,P〈0. 05）,histological differentiation（ Z =- 1. 085,P〈0. 05）,and the rate of intravascular tumor thrombi（ 34. 9% vs 22. 2%,χ2= 0. 949,P〈0. 05）. Conclusion There are no significant differences in the age of onset and progression of disease between patients with HBs Ag（ ＋） and HBs Ag（-） / HBc Ab（ ＋） PHC treated by hepatectomy. However,given the possibility of occult hepatitis B virus infection,it is necessary to monitor hepatic carcinoma even post HBs Ag seroconversion

关 键 词：肝肿瘤 肝炎表面抗原 乙型 肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]