乙肝病毒感染相关性肝癌的临床特征及预后结局特点探讨

摘要

目的:探讨乙肝病毒 (HBV) 感染相关原发性肝癌的临床特征及预后结局特点.方法:选取2008年1月-2017年1月本院收治的原发性肝癌患者429例, 根据是否发生HBV感染将其分为HBV感染组324例与非HBV感染组105例.患者均采取内科保肝对症治疗, 在此基础上, HBV感染组均给予抗病毒治疗, 根据治疗方法将其分为根治疗法组171例与非根治疗法组153例.比较HBV感染组与非HBV感染组的影像及生化特征, 比较根治与非根治疗法组治疗前后的AFP、CA199、Child-Pugh评分, 比较各组1年的生存率.结果:两组肿瘤大小、数目、PVTT、Child-Pugh分级、AFP水平比较, 差异均有统计学意义 (P<0.05) ;治疗12周后, 根治疗法组AFP、CA199、Child-Pugh评分均低于非根治疗法组 (P<0.05) ;根治疗法组1年生存率为78.95％, 高于非根治疗法组的69.93％ (P<0.05) .结论:HBV感染相关的原发性肝癌患者影像及生化特征具有更快的进展速度及更高AFP表达, 临床治疗时应注意针对HBV相关的原发性肝癌患者在抗乙肝病毒基础上选择根治的治疗方法.%Objective:To investigate the clinical features and prognostic outcomes of hepatitis B virus (HBV) infection-related primary liver cance.Method:A total of 429 patients with primary liver cancer admitted to our hospital from January 2008 to January 2017 were selected.According to the occurrence of HBV infection, they were divided into 324 cases of HBV infection group and 105 cases of non-HBV infection group.All patients received symptomatic treatment of liver protection in internal medicine, on this basis, the HBV infection group were given antiviral treatment, according to the treatment methods, the HBV infection group were divided into 171 cases of root therapy group and 153 of non-root therapy group.The imaging and biochemical characteristics of HBV infection group and non-HBV infection group was compared, the AFP, CA199 and Child-Pugh scores before and after treatment of root and non-root therapy group were compared, the 1-year survival rate of each group was compared.Result:The tumor size and number, PVTT, Child-Pugh grade and AFP level in two groups were compared, the differences were statistically significant (P<0.05).After 12 weeks of treatment, the scores of AFP, CA199 and Child-Pugh in root therapy group were lower than those of non-root therapy group (P<0.05).The 1-year survival rate of root therapy group was 78.95％, which was higher than 69.93％of non-root therapy group (P<0.05).Conclusion:The imaging and biochemical characteristics of patients with primary liver cancer associated with HBV infection have a faster progress speed and higher expression of AFP.In clinical treatment, should pay attention to the choice of radical treatment for patients with primary hepatocellular carcinoma associated with HBV on the basis of anti-hepatitis B virus.