HBsAg阴转的慢性乙型肝炎并发肝癌的危险因素分析  

Analyses of risk factors of hepatocellular carcinoma cases with HBsAg seroclearance in chronic hepatitis B

作　　者：陈定贵[1] 郑中伟[1] 龙春梅[1] 钱贤峰[1] 陈晓奇 CHEN Ding - gui;ZHENG Zhong - wei;LONG Chun -mei;et al(Department of Digestive Disease,the Third People＇s Hospital of Changzhou City, Jiangsu Province , Changzhou 213001, China)

机构地区：[1]江苏省常州市第三人民医院消化内科,江苏常州213001

出　　处：《吉林医学》2018年第5期843-844,共2页Jilin Medical Journal

摘　　要：目的:探讨HBsAg阴转的慢性乙型肝炎(乙肝)并发肝癌的危险因素。方法:选择HBsAg阴转的慢性乙肝并发肝癌40例患者为观察组,选取同期的33例HBsAg阴转的非肝癌患者为对照组,回顾性分析HBsAg阴转的慢性乙肝并发肝癌的危险因素。结果:单因素分析表明,男性、HBsAg阴转年龄>50岁、肝硬化、肝癌家族史、HBV DNA(+)是HBsAg阴转的慢性乙肝并发肝癌的危险因素(P<0.05),多因素logistic回归分析结果显示HBsAg阴转年龄>50岁、肝硬化、肝癌家族史是HBsAg阴转的慢性乙肝并发肝癌的独立危险因素(P<0.05)。结论:HBsAg阴转的慢性乙肝患者仍有可能进展为肝癌,HBsAg阴转年龄>50岁、存在肝硬化基础、肝癌家族史是并发肝癌的独立危险因素。对于此类患者,应定期检测AFP、腹部彩超等检查,以排除肝癌可能性。Objective To analyse the risk factors of hepatocellular carcinoma（HCC） patients who achieved HBsAg seroclearance. Method 40 HCC patients with HBsAg seroclearance in chronic hepatitis B were selected as observation group,and 33 patients of HBsAg seroclearance in chronic hepatitis B without HCC as control group. The medical records of the two groups were retrospcctively analyzed to summarize the risk factors of HCC. Results Univariate analysis showed male,HBsAg seroclearance at older ages（ 50 years）,cirrhosis,with family history of HCC,HBV DNA（＋） were significant risk factors of HCC cases with HBsAg seroclearance in chronic hepatitis B（P〈0. 05）. Muhivariate logistic regression analysis identified HBsAg seroclearance at older ages（ 50 years）,cirrhosis,with family history of HCC,HBV DNA（＋） to be independent risk factors of HCC cases with HBsAg seroclearance in chronic hepatitis B（P〈0. 05）. Conclusion HCC can still develop in persons with chronic hepatitis B after HBsAg seroclearance. HBsAg seroclearance at older ages（ 50 years）,cirrhosis,with family history of HCC,HBV DNA（＋） are independent risk factors of HCC cases with HBsAg seroclearance in chronic hepatitis B. Patients may have periodic AFP and liver ultrasound to detect HCC early.

关 键 词：癌 肝细胞 肝炎病毒 乙型肝炎 乙型肝炎表面抗原 转阴 

分 类 号：R512.62[医药卫生—内科学] R735.7[医药卫生—临床医学]