隐匿性HBV感染与原发性肝癌患者的疾病进展及预后的相关性研究

Correlative Study on Occult HBV Infection and Disease Progression and Prognosis of Patients with Primary Liver Cancer

目的探讨隐匿性乙型肝炎病毒(HBV)与原发性肝癌患者的疾病进展及预后的相关性。方法对39例隐匿性HBV感染(试验组)及141例无病毒性(对照组)的PLC患者的肿瘤分化程度、肿瘤大小、肝功能分级及其生化指标进行对比研究,并随访其术后生存率与复发率的差异。结果试验组中11例为突发首次诊断为原发性肝癌,所占比例明显高于对照组;肿瘤>3 cm患者的发生比例明显高于对照组;Child-pugh C肝功能分级明显较对照组严重,两组比较差异均有统计学意义(P<0.05)。试验组患者的AST、TBIL、DBIL水平明显低于对照组,差异有统计学意义(P<0.05);试验组患者术后3年生存率为33.33%,3年生存率明显低于对照组(51.77%),差异有统计学意义(P<0.05);3年复发率为33.33%,明显高于对照组(24.11%),差异有统计学意义(P<0.05)。结论隐匿性HBV感染与原发性肝癌患者的疾病进展、预后关系密切,应予以重视,以防止PLC的进展,提高患者的预后。

Objective To investigate the correlation of the occult hepatitis B virus（ HBV） infection and disease progression and prognosis of primary liver cancer patients. Methods Comparative study on the tumor differentiation,tumor size,Child-Pugh and biochemical indicators of liver,survival rate and recurrence rate between 39 cases of occult HBV infection（ experimental group） and 141 patients without viral infection（ control group） were conducted. Results 11 cases were suddenly diagnosed to be primary liver cancer for the first time,the proportion was significantly higher than that of the control group（ P〈0. 05）. The incidence of tumor larger than 3 cm was significantly higher than that of the control group（ P〈0. 05）. The Child-Pugh C liver function classification was more serious than that of the control group（ P〈0. 05）. The AST,TBIL and DBIL levels of patients in the experimental group was significantly lower than that of the control group,and the difference was statistically significant（ P〈0. 05）; The postoperative 3-year survival rates of the experimental group was 33. 33%,which was significantly lower than that of the control group（ 51. 77%）,and the difference was statistically significant（ P〈0. 05）. 3-year recurrence rate of the experimental group was 33. 33%,which was significantly lower than that of the control group（ 24. 11%）,and the difference was statistically significant（ P〈0. 05）. Conclusion The occult HBV infection is closely related to the disease progression and prognosis of patients with primary liver cancer. We should attach importance to occult HBV infection,in order to prevent the progress of the primary liver cancer and improve the prognosis of patients.