根治性切除联合抗病毒治疗对乙型肝炎病毒相关肝细胞癌的

StephenW

Effect of radical resection combined with antiviral therapy in patients with hepatitis B virus-associated hepatocellular carcinoma and prognostic analysis
Chunfang Xiao  1 , Lili Huang, Nan Xiao, Junjie Lun
Affiliations
Affiliation

    1
    Intervention Operating Room, Changle People's Hospital, Weifang, China.

    PMID: 33455099

Abstract

Purpose: To observe the clinical effect of radical resection combined with antiviral therapy in patients with hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC), and to analyze the risk factors affecting its prognosis.

Methods: The clinical data of 132 patients with HBV-associated HCC treated in our hospital from January 2015 to December 2016 were retrospectively analyzed, and the patients were randomly divided into Control group (n=66) and Anti-virus group (n=66). The changes in liver function indexes, HBV-deoxyribonucleic acid (DNA) load and alpha fetoprotein (AFP) level were compared between the two groups before and after treatment. The tumor recurrence and patients' survival were recorded during the follow-up period, and the possible influencing factors for the prognosis of patients with HBV-associated HCC were analyzed.

Results: After treatment, the levels of alanine aminotransferase (ALT), albumin (ALB), prealbumin (PA) and AFP significantly declined in both groups (p<0.05), while the levels of ALT, PA and AFP were significantly lower in Anti-virus group than those in Control group (p<0.001). After treatment, the HBV-DNA level declined in both groups compared with that before treatment, while it was obviously lower in Anti-virus group than that in Control group (p<0.001). During treatment, the total incidence rate of complications in Anti-virus group was 37.9%, markedly lower than that in Control group 59.1% (p=0.023). The results of log-rank test showed that both OS and PFS rates were far higher in Anti-virus group than those in Control group (p=0.043, p=0.034). The results of Cox multivariate analysis revealed that a low degree of tumor histological differentiation, a large diameter of tumor and no antiviral therapy were independent risk factors affecting the OS rate of patients after treatment (p=0.030, p=0.017).

Conclusions: Antiviral therapy after radical resection of HBV-associated HCC can effectively inhibit the replication of HBV, reduce the recurrence rate of tumor, and prolong the OS of patients. Low grade of tumor histological differentiation, large diameter of tumor and no antiviral therapy are independent risk factors affecting the OS rate of patients after treatment.

StephenW

根治性切除联合抗病毒治疗对乙型肝炎病毒相关肝细胞癌的疗效及预后分析
肖春芳1，黄丽丽，肖楠，伦俊杰
隶属关系
联系

    1个
    潍坊市长乐市人民医院干预手术室

    PMID：33455099

抽象

目的：观察根治性切除联合抗病毒治疗对乙型肝炎病毒（HBV）相关性肝细胞癌（HCC）患者的临床疗效，并分析影响其预后的危险因素。

方法：回顾性分析我院2015年1月至2016年12月收治的132例乙肝相关肝癌患者的临床资料，将患者随机分为对照组（n = 66）和抗病毒组（n = 66）。 ）。比较两组治疗前后肝功能指标，HBV-脱氧核糖核酸（DNA）负荷和甲胎蛋白（AFP）水平的变化。在随访期间记录肿瘤的复发情况和患者的生存情况，并分析与HBV相关的HCC患者预后的可能影响因素。

结果：治疗后，两组丙氨酸转氨酶（ALT），白蛋白（ALB），前白蛋白（PA）和AFP的水平均显着下降（p <0.05），而Anti，ALT，PA和AFP的水平均显着降低-病毒组高于对照组（p <0.001）。治疗后，两组的HBV-DNA水平均较治疗前下降，而抗病毒组的HBV-DNA水平明显低于对照组（p <0.001）。在治疗过程中，抗病毒组并发症的总发生率为37.9％，明显低于对照组的59.1％（p = 0.023）。对数秩检验的结果表明，反病毒组的OS和PFS率均远高于对照组（p = 0.043，p = 0.034）。 Cox多变量分析的结果显示，低的肿瘤组织学分化程度，大的肿瘤直径和未进行抗病毒治疗是影响治疗后OS发生率的独立危险因素（p = 0.030，p = 0.017）。

结论：HBV相关性肝癌根治术后抗病毒治疗可有效抑制HBV的复制，降低肿瘤的复发率，延长患者的OS。肿瘤组织学分化程度低，肿瘤直径大且未进行抗病毒治疗是影响患者治疗后OS率的独立危险因素。