抗病毒治疗对HBV DNA阴性肝细胞癌患者术后肝功能及预后影响  

Influence of antiviral therapy on postoperative liver function and prognosis of HBV DNA-negative patients with HBV related hepatocellular carcinoma

作　　者：任远[1] 刘剑勇[1] 张志明[1] 欧阳高雄 李嘉豪 向邦德[1] REN Yuan;LIU Jian-yong;ZHANG Zhi-ming;OUYANG Gao-xiong;LI Jia-hao;X IANG Bang-de(Department of Hepatobiliary Surgry ,Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021 ,P. R. China)

机构地区：[1]广西医科大学附属肿瘤医院肝胆外科,广西南宁530021

出　　处：《中华肿瘤防治杂志》2018年第5期349-352,358,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：广西科学研究与技术开发计划攻关项目(桂科攻1355005-3-3)

摘　　要：目的抗病毒治疗在乙型肝炎病毒(hepatitis B virus,HBV)相关性肝细胞癌(hepatocellular carcinoma,HCC)患者的治疗中起着重要作用。本研究旨在探讨其对血清HBV DNA阴性HBV相关性HCC患者术后肝功能及预后的影响。方法收集广西医科大学附属肿瘤医院2012-07-01-2015-06-30收治的116例血清HBV DNA阴性HBV相关性HCC患者资料,根据是否行抗病毒治疗将患者分为抗病毒组(41例)与未抗病毒组(75例)。分析比较两组患者术后肝功能状况、复发率和生存率。结果抗病毒组和未抗病毒组丙氨酸氨基转移酶(alanine aminotransferase,ALT)异常率分别为31.7%(13/41)和53.3%(40/75),差异有统计学意义,χ~2=4.382,P=0.036。抗病毒组和未抗病毒组术后肝功能不全的发生率分别为14.6%(6/41)和33.3%(25/75),差异有统计学意义,χ~2=4.544,P=0.033。抗病毒组术后6、12、24个月复发率分别为7.3%、17.1%和26.8%,未抗病毒组分别为13.3%、28.0%和46.7%,两组间总体差异有统计学意义,χ~2=4.098,P=0.043。抗病毒组和未抗病毒组术后6、12、24个月生存率分别为95.1%、90.2%和82.9%,未抗病毒组分别为93.3%、88.0%和78.7%,两组间总体差异无统计学意义,χ~2=0.348,P=0.555。结论在血清HBV DNA阴性HBV相关性HCC患者术后24个月内,抗病毒治疗能保护该类患者术后肝功能,降低复发率,但对生存率的影响不明显。OBJECTIVE To evaluate the influence of antiviral therapy on postoperative liver function and prognosis of HBV related HCC patients with HBV DNA-negative in serum.METHODS Totally 116 cases of HBV DNA-negative patients with HBV related hepatocellular carcinoma were enrolled from our hospital during the period of July 1,2012 to June 30,2015.According to antiviral therapy or not,they were divided into two groups,antiviral group（41 cases）and nonantiviral group（75 cases）.Postoperative liver function,recurrence rate and survival rate were observed and compared.RESULT The abnormal rate of ALT was 31.7%（13/41）in the antiviral group and 53.3%（40/75）in the non-antiviral group.There was significant difference between two groups（χ^2=4.382,P=0.036）.The occurrence rate of hepatic insufficiency was 14.6%（6/41）in the antiviral group and 33.3%（25/75）in the non-antiviral group.There was significant difference between two groups（χ^2=4.544,P=0.033）.The postoperative recurrence rate at 6,12,24 months after surgery were respectively 7.3%,17.1% and 26.8%in the antiviral group and were respectively 13.3%,28.0% and 46.7%in the non-antiviral group.There was significant difference on the disease-free survival curves between two groups（χ^2=4.098,P=0.043）.The survival rate at 6,12 and 24 months after surgery were respectively 95.1%,90.2% and 82.9%in the antiviral group,and were respectively 93.3%,88.0% and 78.7%in the non-antiviral group.There was no significant difference on the survival curves between two groups（χ^2=0.348,P=0.555）.CONCLUSIONS Within 24 months after surgery,antiviral therapy can protect postoperative liver function and reduce recurrence rate,but it has no significant influence on survival rate for HBV related HCC patients with HBV DNA-negative in serum.

关 键 词：抗病毒治疗 乙型肝炎病毒 肝细胞癌 肝功能 预后 

分 类 号：R735.7[医药卫生—肿瘤]