术后乙肝病毒再激活乙肝病毒相关的肝癌患者乙肝病毒DNA水

StephenW

Onco Targets Ther. 2016 Jul 25;9:4593-603. doi: 10.2147/OTT.S104300. eCollection 2016.
Postoperative hepatitis B virus reactivation in hepatitis B virus-related hepatocellular carcinoma patients with hepatitis B virus DNA levels <500 copies/mL.Xie ZB1, Wang XB2, Fu DL3, Zhong JH4, Yang XW5, Li LQ4.
Author information

• 1Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning; Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai.
• 2Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning; Department of Hepatobiliary Surgery, Affiliated Minzu Hospital of Guangxi Medical University.
• 3Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai.
• 4Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning; Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, People's Republic of China.
• 5Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning.
  

AbstractBACKGROUND: Patients with hepatocellular carcinoma have the risk of postoperative hepatitis B virus (HBV) reactivation (PHR). Antiviral therapy was given to patients with detectable HBV DNA levels but not to patients with undetectable HBV DNA levels.
METHODS: In this retrospective study, 258 patients were enrolled (HBV DNA levels <500 copies/mL group, n=159, and HBV DNA levels >500 copies/mL group, n=99).
RESULTS: A total of 50 patients (19.4%) had PHR. The following significant factors related to PHR were found: without antiviral therapy (hazard ratio [HR] =0.17, 95% confidence interval [CI] 0.031-0.911), hepatitis B e antigen positivity (HR =5.20, 95% CI 1.931-14.007), hepatitis B core antigen S1 positivity (HR =2.54, 95% CI 1.116-5.762), preoperative HBV DNA levels ≥500 copies/mL (HR =1.28, 95% CI 1.085-2.884), hepatic inflow occlusion (HR =3.60, 95% CI 1.402-9.277), moderate liver cirrhosis or more (HR =2.26, 95% CI 1.001-5.121), and blood transfusion (HR =2.89, 95% CI 0.836-10.041). Recurrence-free survival time was significantly shorter in patients with PHR (23.06±2.46 months) than in patients without PHR (29.30±1.27 months).
CONCLUSION: Antiviral therapy could efficiently decrease the incidence of PHR. Patients with HBV DNA levels <500 copies/mL still have the risk of PHR. PHR remained as a prognostic risk factor for hepatocellular carcinoma recurrence and recurrence-free survival.


KEYWORDS: HBV DNA levels; hepatectomy; hepatitis B virus; hepatocellular carcinoma; postoperative reactivation

PMID:27524913DOI:10.2147/OTT.S104300

StephenW

ONCO瞄准疗法。 2016年7月25日; 9：4593-603。 DOI：10.2147 / OTT.S104300。 eCollection 2016年。
术后乙肝病毒再激活乙肝病毒相关的肝癌患者乙肝病毒DNA水平<500拷贝/毫升。
谢ZB1，王XB2，傅DL3，钟JH4，杨XW5，李LQ4。
作者信息

    肝胆外科教研室，广西医科大学，南宁附属肿瘤医院;胰腺外科，胰腺疾病研究所，华山医院，上海医学院，复旦大学，上海。
    肝胆外科教研室，广西医科大学，南宁附属肿瘤医院;肝胆外科，广西医科大学附属医院民族。
    胰腺外科3Department，胰腺疾病研究所，华山医院，上海医学院，复旦大学，上海。
    肝胆外科4Department，广西医科大学，南宁附属肿瘤医院;广西肝癌的诊断与治疗工程技术研究中心，南宁，中国的人民共和国。
    肝胆外科5Department，广西医科大学，南宁附属肿瘤医院。

抽象
背景：

肝癌患者术后有乙型肝炎病毒（HBV）重新激活（PHR）的风险。抗病毒治疗是给患者检测HBV DNA水平，但不会给患者检测不到的HBV DNA水平。
方法：

在此回顾性研究中，258例患者（HBV DNA水平<500拷贝/ ml组，n = 159，和HBV DNA水平> 500拷贝/ ml组，n = 99）。
结果：

总共有50例（19.4％）有PHR。涉及到PHR以下显著因素被发现：没有抗病毒治疗（风险比[HR] = 0.17，95％置信区间[CI] 0.031-0.911），乙肝e抗原阳性（HR = 5.20，95％CI 1.931-14.007 ），乙肝核心抗原阳性S1（HR = 2.54，95％CI 1.116-5.762），术前HBV DNA水平≥500拷贝/ mL（HR = 1.28，95％CI 1.085-2.884），入肝血流阻断（HR = 3.60 ，95％CI 1.402-9.277），中度肝硬化以上（HR = 2.26，95％CI 1.001-5.121）和输血（HR = 2.89，95％CI 0.836-10.041）。无复发生存期为患者显著缩短与PHR（23.06±2.46个月）的患者比没有PHR（29.30±1.27个月）。
结论：

抗病毒疗法可有效降低功率余量的发生率。患者HBV DNA水平<500拷贝/ ml仍然有PHR的风险。 PHR仍然是肝癌复发和无复发生存预后的危险因素。
关键词：

HBV DNA水平;肝切除术;乙型肝炎病毒;肝细胞癌;术后激活

结论：
    27524913
DOI：
    10.2147 / OTT.S104300