| 摘要: |
| 目的探讨血清乙型肝炎病毒脱氧核糖核苷酸（HBVDNA）水平及术后抗病毒治疗对HBV相关性肝细胞癌（HCC）患者行根治性切除术后预后的影响。方法回顾性分析行肿瘤根治性切除术的701例HBV相关性HCC患者，分析患者临床病理资料与术后预后的关系。结果平均随访64.5个月后，肿瘤复发450例（64.2%），死亡217例（35.3%）。单因素分析发现HBeAg阳性、AST＞37U/L、HBVDNA≥2000U/ml、γ-谷氨酰转肽酶（γ-GT）＞61U/L、碱性磷酸酶（AKP）＞129U/L、PT＞13s、甲胎蛋白（AFP）＞20滋g/L、肿瘤个数≥2、肿瘤直径较大、肿瘤切距＜1cm、肿瘤无包膜、门静脉癌栓、微血管癌栓、肝硬化、肿瘤pTNM分期越高，患者术后肿瘤复发的风险较大。多因素分析发现HBeAg阳性、γ-GT＞61U/L、PT＞13s、肿瘤个数≥2、肿瘤直径较大、门静脉癌栓及肿瘤切距＜1cm均为患者术后复发的独立危险因素。术前HBVDNA≥2000U/ml的患者，抗病毒组患者复发率低于未抗病毒组患者（P＜0.01）。结论HBVDNA水平较高与HCC患者行根治性切除术后复发的高风险相关，抗病毒治疗能减少HCC患者根治性切除术后复发。 |
| 关键词: 肝细胞癌 复发 抗病毒治疗 |
| DOI：10.12056/j.issn.1006-2785.2018.40.1.2017-1717 |
| 分类号: |
| 基金项目:国家自然科学基金（项目编号：81672371） |
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| Effect of serum HBV DNA and antiviral treatment on prognosis of HBV-related hepatocellular carcinoma following resection |
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Lishui Central Hospital
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| Abstract: |
| Objective To investigate the effect of serum HBV DNA level and antiviral therapy on the prognosis of HBV-related hepatocellular carcinoma (HCC) following curative resection. Methods Total 701 HBV-related HCC patients who underwent curative resection in Eastern Hepatobiliary Surgery Hospital from October 2009 to August 2010 were enrolled in the study. The association of clinical variables with the prognosis of HCC was analyzed. Results During a follow-up of 64.5months,
the HCC recurrence occurred in 450 patients(64.2%) and 217 patients(35.3%) died. Univariate analysis revealed that HBeAg seropositivity, AST＞37 U/L, HBV DNA≥2 000 U/ml,γ-GT＞61 U/L, AKP＞129 U/L, PT＞13 s, AFP＞20 滋g/L, tumor number≥2, larger tumor size, cutting margin＜1 cm, no capsule formation, portal vein invasion, microvascular invasion, cirrhosis, higher rank
of pTNM stage were associated with a higher cumulative incidence of HCC recurrence. Multivariate analyses showed that HBeAg seropositivity, γ-GT ＞61 U/L, PT ＞13s, tumor number ≥2, larger tumor size, portal vein invasion, cutting margin ＜1 cm were independently associated with a increased risk of recurrence. For HCC patients with HBV DNA≥2 000 U/ml, the recurrence rate in patients receiving antiviral treatment was lower than those without antiviral treatment (P＜0.01). Conclusion High levels of HBV DNA increased the risk of HCC recurrence following curative resection, and antiviral treatment may reduce the recurrence after curative resection in HCC. |
| Key words: Hepatocellular carcinoma Recurrence Antiviral treatment |
