HBV—DNA阴性肝癌肝动脉化疗栓塞后HBV再激活的临床研究

Hepatitis B virus reactivation in HBV DNA-negative patients with hepatoceHular carcinoma after transarterial chemoembolization

目的探讨HBV—DNA阴性HBV相关性肝癌患者行肝动脉化疗栓塞（TACE）后乙肝病毒（HBV）再激活的危险因素。方法研究纳入2012年8月至2015年9月，在苏州大学附属第一医院行TACE治疗的HBV—DNA阴性HBV相关性肝癌且术后至少随访6个月的患者。统计分析HVB激活情况及危险因素。结果根据纳入和排除标准，在纳入研究的99例患者中，随访期间发生HBV再激活24例（24．2％）。与HBV未激活患者比较，HBV再激活患者转氨酶水平显著升高，差异有统计学意义（P〈0．05）。分析显示HbeAg阳性、肿瘤数目〉3个是HBV再激活的独立危险因素。结论HBV—DNA阴性HBV相关性肝癌患者TACE术后存在HBV再激活风险。

Objective To evaluate risk factors of hepatitis B virus （HBV） reactivation after transarterial chemoembolization （TACE） in patients with HBV-related hepatocellular carcinoma （HCC） with undetectable HBV DNA levels. Methods From August 2012 to Sepemter 2015, all patients who underwent TACE for HBV-related HCC with HBV DNA level less than 103 copies/ml in the First Affiliated Hospital of Soochow University were enrolled into the study. These patients were followed-up for at least 6 months after TACE to assess HBV reactivation. Univariate and multivariate logistic regression analyses were done to evaluate the risk factors related to HBV reactivation in these patients. Results With predetermined inclusion and exclusion criteria, 99 patients were enrolled into the study. Twenty-four patients （24.2%） developed HBV reactivation after TACE in the followed-up period. The level of transaminase was significantly higher in the HBV reactivation group than the non HBV reactivation group （P 〈 0.05）. HBeAg positivity and tumors more than 3 in number were independent risk factors of HBV reactivation. Conclusion HCC patients with undetectable levels of HBV DNA had a significant risk of HBV reactivation after TACE.