HBV相关性原发性肝癌行综合治疗后HBV炎症与肿瘤复发的关系

摘要

目的 总结乙型肝炎病毒(HBV)相关性原发性肝癌(肝癌)肝叶切除为主的综合治疗后HBV炎症与肿瘤复发之间的关系.方法 回顾性分析646例肝癌患者的临床资料.采用KaplanMeier法计算肝癌行肝切除术为主的综合治疗后生存率和无瘤生存率,Log-rank检验比较组间差异.结果 646例肝癌患者行肝切除术为主的综合治疗后1、3和5年总生存率分别为76.12%、52.65%和38.18%,无瘤生存率分别为82.54%、62.17%和41.90%.HBV低复制组1年肿瘤复发率为22.17%;HBV高复制组1年肿瘤复发率为47.32%.两者比较差异有统计学意义(P＜0.05).结论 HBV的复制程度是影响肝癌综合治疗患者生存率及无复发生存率的独立预后因素,抗病毒治疗可以抑制病毒复制,延缓肿瘤复发,延长生存时间.%Objective To summarize the outcomes of hepatectomy in patients with HBV infection-related hepatocellular carcinoma (HCC). Methods The data of 646 patients with HBV-related HCC underwent hepatectomy were retrospectively analyzed. The overall survival and recurrence rates were calculated with Kaplan-Meier survival curve. Results The 1-, 3- and 5-year overall survival rates were 76. 12％ ,52. 65％ and 38. 18％, and the recurrence-free survival rates were 82. 54％,62. 17％ and 41. 90％. In the patients with low and high replication of HBV-DNA, the 1-year tumor recurrence rates were 22. 17％ and 47. 32％ (P＜0. 05). Conslusion The high replication of HBV-DNA is an indepandent factor in influencing survival and recurrence in HBV infection-related HCC patients after hepatectomy, in whom perioperative antivirus therapy may suppress the HBV reaction,delay the recurrence and prolong the survival.