拉米夫定在肝癌介入栓塞化疗中的作用

Therapeutic Effects of Lamivudine and Transarterial Chemoembolization in Primary Hepatocellular Carcinomar

目的探讨拉米夫定在肝癌介入栓塞化疗中的作用。方法回顾性分析拉米夫定联合介入栓塞化疗治疗HBV相关原发性肝癌17例,并与同期单独介入栓塞化疗患者15例对比。结果两组年龄、性别、肿瘤大小及实验室检查及一般状况评分等基线资料比较无统计学差异(P>0.05);对照组中有4例提前终止治疗,均因III度以上肝功能损伤并HBV-DNA水平均较治疗前升高10倍以上;研究组2例提前终止治疗,其中1例因为III度肝功能损伤无治疗后HBV-DNA水平明显升高,另1例因为严重肺部感染。研究组1年生存率、2年生存率及中位生存期分别是94.12%、82.35%和27.54个月,对照组为93.33%、66.67%和20.43个月;两组比较有统计学差异(P<0.05)。结论肝动脉栓塞化疗对病毒活动存在激发作用,而抗病毒药物拉米夫定可预防和治疗肝动脉栓塞化疗期间病毒活跃,保障抗肿瘤治疗的顺利进行,从而提高生存率、延长生存期。有必要开展深入研究,以进一步明确抗病毒治疗在肝癌综合治疗中的作用。

Objective To investigate the efficacy oflamivudine and transarterial chemoembolization in primary hepatocellular carcinomar. Methods 32 primary hepatocellular carcinomar patients with hepatitis B virus infection were retrospectively analyzed.They were divided into two groups. In research group,17 patients had received lamivudine and transarterial chemoembolization（TACE） and 15 patients in control group had undergone transarterial chemoembolization only. Results There were no significant differences between two groups in basic clinical materials,such as age,sex,tumor size, laboratory examination and performance status score,etc（P〉0.05）.4 patients in the contral group had to stop treatment because of upper three grade liver function damagement with copies of HBV-DNA 10 folds higher than before. 2 patients in the research group had to stop treatment. One was because of three grade liver function damagement without copies of HBV-DNA higher than before,and the other one was because of serious infection in lung.The survival rates of 1 year, 2 years and the median survival time in reasearch group were 94.12%, 82.35% and 24.57 months, while that of contral group were 93.33%, 66.67% and 20.43 months, showing significance（P〈0.05）.Conclusion TACE may promote the process of HBV replication.The activity of HBV can be inhibited by laminvudine to ensure TACE proceed smoothly and improve surviving.It deserves further study to identify the action ofantivirus treatment in combined therapy in liver cancer.