肝炎病毒感染与肝细胞性肝癌患者术后复发转移的相关性研究  

Correlation between hepatitis virus infections and postoperative recurrence and metastasis of hepatocellular carcinoma

作　　者：吴卫兵[1] 尹华发[1] 黄文琪[2] 闵峰[2] 张丽[2] 

机构地区：[1]安徽医科大学第一附属医院感染科,安徽合肥230022 [2]安徽医科大学解放军174临床学院感染科,福建厦门361004

出　　处：《中华医院感染学杂志》2016年第4期744-746,共3页Chinese Journal of Nosocomiology

基　　金：南京军区科技创新基金资助项目(14MS083)

摘　　要：目的探讨单纯及合并乙型肝炎病毒(HBV)与丙型肝炎病毒(HCV)感染对肝细胞性肝癌患者手术后癌症复发转移的影响,以及HBV、HCV感染对患者术后复发转移的可能因素,以指导临床采取适当时机进行治疗。方法选取2010年3月-2013年10月安徽医科大学第一附属医院肝胆外科施行肝癌根治性切除手术的肝细胞性肝癌患者作为研究对象,从术后6个月的患者中随机选取90例,对其进行HBV和HCV感染检测,根据检测结果将患者分为A、B、C、D组,A组为HBV(-)、HCV(-);B组为HBV(+)、HCV(-);C组为HBV(-)、HCV(+);D组为HBV(+)、HCV(+),对比单纯及合并HBV、HCV病毒感染对患者肝癌复发转移率的影响,并回顾性分析患者临床病理资料,探讨病毒感染对患者术后复发转移的影响因素。结果 ELISA法检测到HCV感染阳性9例,阳性率为10.0%,nRT-PCR法检测HCV阳性25例,阳性率为27.8%,两种检测方法差异有统计学意义(P<0.05);D组患者术后复发率较A、B、C组高,差异有统计学意义(P<0.05);B、C组患者的术后复发率显著高于A组患者(P<0.05),B、C两组患者间肝癌复发率差异无统计学意义;患者年龄、肿瘤大小、肝硬化程度以及肿瘤分化程度在A、B、C、D组间,差异有统计学意义(P<0.05)。结论 nRT-PCR法检测HCV感染的特异性更高,HBV和HCV感染对肝细胞性肝癌患者术后更易复发转移。OBJECTIVE To explore the impact of single infection or coinfection of hepatitis B virus（HBV）and hepatitis C virus（HCV）on postoperative recurrence and metastasis of hepatocellular carcinoma and find out the potential influencing factors so as to provide guidance for appropriate clinical treatment.METHODS The patients with hepatocellular carcinoma who underwent the radical resection of liver cancer in the hepatobiliary surgery department of the First Affiliated Hospital of Medical University of Anhui from Mar 2010 to Oct 2013 were recruited as the study objects,and 90 patients were randomly selected from the patients who underwent the surgery after 6months.The HBV and HCV infections were detected,and the patients were divided into the group A,B,C,and D according to the detection results：the group A negative for both HBV and HCV,the group B positive for HBV and negative for HCV,the group C negative for HBV and positive for HCV,the group D positive for both HBV and HCV.The impact on the recurrence and metastasis rate of hepatocellular carcinoma was observed and compared between the single infection and the coinfection of HBV and HCV,the clinical pathological data of the patients were retrospectively analyzed,and the influencing factors for the postoperative recurrence and metastasis were explored.RESULTS The HCV infection was detected positive in 9cases by using ELISA method,with the positive rate 10.0%;the HCV was detected positive in 25 cases by using nRT-PCR method,with the positive rate27.8%,and there was significant difference between the two detection methods（P 0.05）.The rate of postoperative recurrence was significantly higher in the group D than in the group A,B,and C（P〈0.05）;the rate of postoperative recurrence was significantly higher in the group B and C than in the group A（P〈0.05）;there was no significant difference in the recurrence rate of liver cancer between the group B and the group C.There was significant difference in the age,size of tumor,degree of liver cirrhosis,or degr

关 键 词：乙型肝炎病毒 丙型肝炎病毒 复发转移 肝细胞性肝癌 

分 类 号：R373.2[医药卫生—病原生物学]