抗病毒治疗在预防HBV DNA阴性的肝细胞癌术后复发中的影响  

The influence of antiviral therapy in the prevention of postoperative recurrence of HBV DNA negative HCC

作　　者：顾炜[1] 张智勇 吴鸣宇[1] GU Wei;ZHANG Zhiyong;WU Mingyu(Department of Hepatobiliary Surgery,the Affiliated Wuxi People's Hospital of Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学附属无锡市人民医院肝胆外科,南京医科大学无锡医学中心,江苏无锡214023 [2]南京医科大学附属无锡市人民医院健康管理中心,南京医科大学无锡医学中心,江苏无锡214023

出　　处：《全科医学临床与教育》2024年第6期510-513,共4页Clinical Education of General Practice

基　　金：无锡市卫生健康委2022年度科研面上项目(M202254)。

摘　　要：目的探讨抗病毒药物治疗对乙肝病毒(HBV)DNA阴性的肝细胞癌(HCC)患者预防术后复发的影响。方法80例HBV DNA阴性的HCC患者随机分为两组。抗病毒组给予手术切除+术后常规预防性经肝动脉化疗栓塞术(TACE)+术前预防性抗病毒治疗,40例;对照组给予手术切除+术后常规预防性TACE治疗,40例。术后随访2年,比较两组患者术后HBV再激活率,观察两组患者术后6个月、1年、2年复发率。结果术后随访2年,对照组出现HBV再激活29例(72.50%),抗病毒组出现HBV再激活3例(7.50%),两组HBV再激活率比较,差异有统计学意义(χ^(2)=5.43,P<0.05)。抗病毒组术后6个月、1年、2年复发率均明显低于对照组,差异有统计学意义(χ^(2)分别=8.35、11.61,P均<0.05)。多因素分析结果显示:给予抗病毒治疗是影响HCC术后复发的保护因素(OR=0.27,P<0.05)。结论对于HBV DNA阴性的HCC患者进行预防性抗病毒治疗,能有效减少HBV再激活,有助于降低术后2年内的肿瘤复发率。Objective To investigate the effect of antiviral therapy on the prevention of postoperative recurrence in patients with HBV DNA negative hepatocellular carcinoma(HCC).Methods Totally 80 HCC patients with negative HBV DNA were randomly divided into two groups.The antiviral group was received surgical resection combined with postoperative routine prophylactic transhepatic arterial chemoembolization(TACE)combined with preoperative prophylactic antiviral treatment,40 cases.The control group was received surgical resection combined with postoperative routine preventive TACE treatment,40 cases.The HBV reactivation rate was compared between the two groups and the recurrence rate was observed at 6 months,1 year and 2 years after surgery.Results After 2 years of following-up,HBV reactivation occurred in 29 cases(72.50%)in the control group and 3 cases(7.50%)in the antiviral group.The difference in HBV reactivation rate between the two groups was statistically significant(χ^(2)=5.43,P<0.05).The recurrence rate of antiviral group at 6 months,1 year and 2 years after operation was significantly lower than that of control group,with statistical significance(χ^(2)=8.35,11.61,P<0.05).Multivariate analysis showed that antiviral therapy was a protective factor for postoperative recurrence of liver cancer(OR=0.27,P<0.05).Conclusion Prophylactic antiviral therapy can effectively reduce HBV reactivation in HCC patients with negative HBV DNA,and help reduce the recurrence rate of tumor within 2 years after surgery.

关 键 词：肝细胞癌 乙肝病毒DNA 阴性 抗病毒 术后复发率 

分 类 号：R735.7[医药卫生—肿瘤]