化疗对HBsAg阳性乳腺癌患者肝功能的影响

Hepatic dysfunction during chemotherapy in breast cancer patients with positive HBsAg

目的探讨周期性化疗对乙肝病毒表面抗原(HBsAg)阳性的乳腺癌患者肝功能的影响。方法对98例乳腺癌患者以同一方案正规化疗2～6个周期,观察肝功能指标和外周血HBVDNA含量变化及临床相关症状。结果(1)化疗2周期HBsAg阳性的乳腺癌组肝损害发生率为3684%,阴性组发生率为1333%(P<001)。(2)化疗4周期辅以保肝治疗,HBsAg阳性组肝损害发生率为2580%,阴性组发生率为689%,比2周期明显下降(P<005)。(3)化疗6周期继续保肝治疗,HBsAg阳性组肝损害发生率1428%,阴性组发生率517%(P>005)。结论乙肝病毒慢性感染的乳腺癌接受细胞毒化疗时容易出现肝损害,保肝治疗可以降少肝损害的发生。

Objective To investigate the effect of chemotherapy on hepatic function in breast cancer patients with chronic hepatitis B virus (HBV) infection Methods In this study, 98 breast cancer patients received two to six courses of standard chemotherapy, alterations in hepatic function and blood HBV DNA level were measured and clinical symptom was observed Results (1) After two courses of chemotherapy, hepatic damage was observed in 36 84 % and 13 33% respectively in HBsAg positive and negative breast cancer patients ( P <0 01) (2) In patients receiving four courses of chemotherapy with liver function protection therapy, a dramatic decrease in hepatic damage compared with 2 courses regimen was found, with incidences of 25 80% in HBsAg positive group and 6 89% in negative group ( P <0 05) (3) A further decrease in hepatic damage was obtained in patients receiving six courses of chemotherapy with hepatic protection intervention, with incidences of 14 28% in positive group and 5 17% in negative group ( P <0 05) Conclusion Breast cancer patients with chronic HBV infection were subject to hapatic damage when receiving chemotherapy and hepatic protection treatment may ameliorate the occurrence of hepatic damage