HBV感染抗病毒治疗中发生肝细胞癌24例临床分析

Clinical analysis of 24 cases of hepatocellular carcinoma happened that hepatitis B virus infection was treated in the process of antiviral

目的探讨HBV感染抗病毒治疗过程中发生肝细胞癌(HCC)的原因和诊断方法。方法回顾性分析24例HBV感染(肝炎后肝硬化者18例、CHB者6例)抗病毒治疗过程中发生HCC的病例,分析其发生原因及诊断方法。结果 HBV感染抗病毒过程中发生HCC常见。患肝病时间、男性、抗病毒治疗效果不佳(或发生病原学突破)、吸烟、饮酒、糖尿病是抗病毒治疗过程中发生HCC常见原因。肝硬化发展至肝癌常无症状,慢性肝炎发展至肝癌常有肝区不适、生物化学检测结果异常、HBV载量变化。AFP、彩色多普勒超声、CT联合检查基本可以完成HCC的临床诊断,必要时辅以肝脏病理学检查。结论 HBV感染抗病毒过程中发生HCC常见,提高认识有利于早期发现HCC。

Objective To investigat causes and diagnosis method of hepatocellular carcinoma that hepatitis B virus infection was treated in the process of antiviral. Methods The causes and diagnosis method was retrospective analysed of 24 cases of hepatocellular carcinoma （18 cases of posthepatitic liver cirrhosis, 6 cases of chronic hepatitis B） that hepatitis B virus infection was treated in the process of antiviral. Results The hepatocellular carcinoma was more common that hepatitis B virus infection was treated in the process of antiviral. The the most common cause of hepatocellular carcinoma happened that hepatitis B virus infection was treated in the process of antiviral is the time of liver disease, male, poor effect of antiviral treatment （or pathogenic breakthrough）, diabetes. It is often asymptomatic from liver cirrhosis to hepatocellular carcinoma. The progression of chronic hepatitis to hepatocellular carcinoma often has liver area unwell, biochemical changes, changes in the amount of the hepatitis B virus. Clinical diagnosis of hepatocellular carcinoma was completed with alpha-fetoprotein （AFP）, color doppler ultrasound, CT, and the liver pathology was implemented. Conclusions The hepatocellular carcinoma was more common that hepatitis B virus infection was treated in the process of antiviral. Raising awareness is helpful for early diagnosis of HCC.