老年肝细胞癌患者手术前后HBV-DNA及肝功能变化的研究

Change of HBV-DNA and liver function before and after surgery in patients with hepatic cellular cancer

目的研究老年肝细胞癌患者行肝癌根治术前后HBV-DNA载量及肝功能变化,并探讨HBV-DNA载量对于术后患者肝功能恢复状况的预测价值。方法分析201 1年1月一2013年1月在本院接受住院手术治疗的肝细胞癌患者的临床资料,根据术前HBV-DNA载量分为阴性组、低复制组、中复制组和高复制组四组。比较4组患者术前术后的HBV-DNA载量及肝功能变化。结果本研究共入组患者65例,其中阴性组10例,低复制组27例,中复制组18例和高复制组10例。手术治疗1周后,阴性组和低复制组患者的HBV-DNA载量有所下降,而中、高复制组载量有所升高,但差异均无统计学意义(P均>0.05);4组患者术后第一天的ALT、AST水平均显著高于术前水平(P均<0.01),Alb水平有所下降,差异有统计学意义(P均<0.05)。TBIL,术前术后差值并无统计学意义(P均>0.05);术前HBV-DNA载量对术后患者肝功能恢复时间的预测价值曲线下面积为0.901,敏感性为77.65%,特异性为87.24%。结论 HCC患者手术后的HBV的复制仍然很活跃,术前HBV-DNA载量对于术后患者肝功能恢复时间有着一定的预测价值。

Objective To analyze the change of HBV-DNA and liver function before and af-ter surgery in patients with hepatic cellular cancer.Methods Clinical materials of patients with were retrospectively analyzed.They were divided into 4 groups according to the level of HBV-DNA before surgery.Results The liver function of patients decreased significantly after surgery.The.There was no significant difference of TBIL before and after operation.ROC of preoperative HBV-DNA value in prediction of recovery time of postoperative liver function was 0.901,sensitivity was 77.65%,and specificity was 87.24%.Conclusion Level of HBV-DNA shows a significant meaning in the predic-tion of the recovery time of liver function.