乙型肝炎病毒—相关肝细胞癌患者行微波消融术治疗后复发相关因素分析  

Relative factors analysis of recurrence after microwave ablation of hepatitis B virus-hepatocellular carcinoma

作　　者：郭欣 霍传红[1] 解景东 黄凯[1] Guo Xin;Huo Chuanhong;Xie Jingdong;Huang Kai(Department of Infection,Dezhou People′s Hospital,Dezhou 253000,China)

机构地区：[1]德州市人民医院感染科,山东德州253000

出　　处：《中国临床实用医学》2020年第4期48-51,共4页China Clinical Practical Medicine

摘　　要：目的:探讨炎症因子在乙型肝炎病毒(HBV)—相关肝细胞癌(HCC)患者行微波消融术(MWA)治疗后复发情况及临床意义。方法:选取2016年12月至2019年12月德州市人民医院感染科收治的92例行MWA治疗的HBV-HCC患者,男49例,女43例,年龄(60.25±3.51)岁,年龄范围为52~73岁。按照MWA治疗后是否复发分为复发组(n=28)与未复发组(n=64)。采用单因素及logistic多因素分析探讨临床指标及炎症因子与MWA治疗后复发的相关性。结果:复发组与未复发组年龄、性别、病灶数、巴塞罗那(BCLC)分期、白细胞介素-2水平、白细胞介素-6水平、白细胞介素-8水平、白细胞介素-10水平、白细胞介素-23水平、肿瘤坏死因子-α水平比较,差异均无统计学意义(P>0.05)。复发组肿瘤直径>10 cm的患者所占比例[60.7%(17/28)]高于未复发组[32.8%(21/64)],差异有统计学意义(P<0.05)。白细胞介素-17(IL-17)水平[(1.25±0.42)pg/ml]高于未复发组[(0.46±0.15)pg/ml],差异有统计学意义(P<0.05)。logistic多因素分析结果可见,IL-17水平与肿瘤最大直径>10 cm可作为HBV-HCC行MWA治疗后复发的高危因素,差异有统计学意义(P<0.05)。结论:IL-17水平与肿瘤最大直径>10 cm能够作为HBV-HCC行MWA治疗后复发的高危因素,在临床治疗时需要对其引起足够的重视。Objective To investigate the level and clinical significance of inflammatory factors in recurrence after microwave ablation(MWA)in patients with hepatitis B virus(HBV)-hepatocellular carcinoma(HCC).Methods 92 patients with HBV-HCC who were treated with MWA from December 2016 to December 2019 in the department of Infection,Dezhou People′s Hospital.There were 49 males and 43 females,aged(60.25±3.51)years old,and ranging from 52 to 73 years old.According to whether relapse after MWA treatment,patients were divided into the recurrence group(n=28)and non-recurrence group(n=64).Univariate and logistic multivariate analysis was used to investigate the correlation between clinical parameters and inflammatory factors and relapse after MWA treatment.Results Age,gender,number of lesions,BCLC stage,interleukin-2 level,interleukin-6 level,interleukin-8 level,interleukin-10 level,interleukin-23 level,and tumor necrosis factor-level were not significantly different between the recurrence group and the non-recurrence group(P>0.05).The percentage of patients with tumor diameter>10 cm in the recurrence group was higher than that in the non-recurrence group[60.7%(17/28),P<0.05].The level of interleukin-17(IL-17)in the recurrence group[(1.25±0.42)pg/ml]was significantly higher than[(0.46±0.15)pg/ml]in the non-recurrence group,(P<0.05).Logistic analysis showed that IL-17 level and tumor diameter>10 cm were significant risk factors for recurrence of HCC after MWA therapy(P<0.05).Conclusion IL-17 level and tumor maximum diameter of>10 cm can be used as high risk factors for recurrence of HBV-HCC after MWA treatment,which should be paid enough attention in clinical treatment.

关 键 词：炎症因子 乙型肝炎病毒—相关肝细胞癌 微波消融术 复发 白细胞介素 肿瘤坏死因子-Α 

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