TACE联合抗病毒治疗对乙型肝炎病毒感染相关性肝癌患者的疗效及预后影响  

Efficacy and prognosis of TACE combined antiviral therapy in patients with hepatitis B-related liver cancer

作　　者：杨定康 沈昌山 YANG Dingkang;SHEN Changshan(Department of Infectious Disease,Tianchang People’s Hospital,Tianchang 239300,Anhui,China;Department of Interventional,Tianchang People’s Hospital,Tianchang 239300,Anhui,China)

机构地区：[1]天长市人民医院感染科,安徽天长2393000 [2]天长市人民医院介入科,安徽天长2393000

出　　处：《癌症进展》2019年第24期2962-2964,2968,共4页Oncology Progress

摘　　要：目的探讨经皮肝动脉栓塞化疗(TACE)联合抗病毒治疗乙型肝炎(简称乙肝)病毒感染相关性肝癌患者的疗效及预后的影响。方法按照随机数字表法将80例乙肝病毒感染相关性肝癌患者分为联合组和对照组,各40例。联合组采用TACE联合恩替卡韦治疗,对照组采用TACE治疗。比较两组患者治疗后的临床疗效,治疗前后血清丙氨酸转氨酶(ALT)、乙肝病毒脱氧核糖核酸(HBV-DNA)、甲胎蛋白(AFP)水平;随访2年,比较两组患者累积生存率及预后。结果治疗后,联合组患者的客观缓解率(ORR)为67.5%高于对照组患者的45.0%(P﹤0.05);治疗24周和48周后,联合组患者的血清HBV-DNA、ALT和AFP水平均低于对照组患者(P﹤0.05)。随访2年,联合组患者的2年累积生存率39.47%,高于对照组患者的27.03%,但差异无统计学意义(P﹥0.05)。联合组患者的中位生存时间22.0个月,高于对照组患者的17.0个月(P﹤0.05)。结论TACE联合抗病毒疗法治疗乙肝病毒感染相关性肝癌较单纯的TACE疗法可提高化疗效果、达到抗病毒目的,对延长患者生存时间具有一定的临床价值。Objective To investigate the efficacy and prognosis of percutaneous transhepatic arterial chemoembolization(TACE)combined antiviral therapy in patients with hepatitis B-related liver cancer.Method Based on random number table method,80 patients with hepatitis B-related liver cancer were divided into the combination group and the control group,40 cases each.The combination group was treated with TACE and entecavir,and the control group with TACE;compare the clinical effect of the two groups often treatment,serum alanine aminotransferase(ALT),hepatitis B virus-DNA(HBV-DNA)andα-fetoprotein(AFP)levels of two groups were compared before and after treatment,and the cumulative survival rate and prognosis were compared after 2 years of follow-up.Result After treatment,the objective remission rate(ORR)of the combination group(67.5%)was significantly higher than the control group(45.0%)(P<0.05);24 and 48 weeks after treatment,the serum HBV-DNA,ALT and AFP levels of the combination group were significantly lower than those of the control group(P<0.05).The 2-year cumulative survival rate of the combination group(39.47%)was higher than the control group(27.03%),with no significant difference(P>0.05).The median survival time of the combination group(22.0 months)was significantly higher than the control group(17.0 months)(P<0.05).Conclusion TACE combined antiviral therapy in the treatment of hepatitis B-related liver cancer can improve the effect of chemotherapy and achieve antiviral purpose,which is clinically helpful in prolongation of the survival time of patients.

关 键 词：经皮肝动脉栓塞化疗 乙型肝炎 肝癌 预后 

分 类 号：R735.7[医药卫生—肿瘤]