HBV DNA阳性的中晚期肝癌预后因素分析及抗病毒治疗对生存期的影响

摘要

目的 探讨HBV DNA阳性的中晚期原发性肝癌(PHC)预后的影响因素及抗病毒治疗对患者生存的影响.方法 选择HBV DNA阳性的93例中晚期肝癌患者临床指标和随访资料,采用Kaplan-Meier法及Cox比例风险回归模型对可能影响其预后的因素进行单变量和多变量回归分析,重点分析病毒载量及核苷(酸)类似物抗病毒治疗对肝癌预后的影响.结果 除GGT、Child-Pugh分级、门脉癌栓、治疗方式、治疗次数外,抗病毒治疗也是影响患者预后的重要因素,而病毒载量对预后无统计学意义(P＞0.05).结论 虽病毒载量并不影响HBV DNA阳性患者的生存期,但抗病毒治疗仍是影响生存的重要因素,对于HBV DNA阳性的中晚期肝癌应积极抗病毒治疗,以期改善患者的生存.%Objective To investigate the prognostic factors and effects of antiviral therapy on advanced PHC patients with HBV DNA positive. Methods The clinical and laboratory data of 93 patients with advanced stage and HBV DNA positive were selected. The factors affecting the prognosis were analyzed by Kaplan-Meier and Cox proportional hazard model, focusing on analysis of viral load and antiviral therapy on the PHC. Results Besides GGT, liver function of Child-Pugh classification, portal vein tumor thrombus, integrated treatment and number of treatment, antiviral therapy were important prognostic factors, while viral load on the prognosis of PHC were non-significant. Conclusion Although viral load does not affect the survival of patients, but the antiviral therapy is still an important factor affecting patient survival with advanced PHC with HBV DNA positive, so we should take antiviral therapy actively to improve patient survival.