核苷类抗病毒治疗对慢性乙型肝炎相关性肝癌患者术后预后的影响

Nucleoside antiviral therapy for HBV-related hepatic carcinoma:Observation of post-operative prognosis

目的探讨核苷类抗病毒治疗对慢性乙型肝炎(以下简称"慢乙肝")相关性肝癌患者术后预后的影响。方法回顾性分析2010年3月至2014年3月间浙江省宁波区奉化人民医院收住的100例乙型肝炎病毒-脱氧核糖核酸(HBV-DNA)阳性的慢乙肝相关性肝癌术后患者,50例对照组采用单纯手术切除或加肝动脉化疗栓塞术(TACE)治疗,50例治疗组采用手术切除或加TACE术后核苷类抗病毒治疗。结果治疗2年和3年结果显示,治疗组和对照组HBV-DNA清除率分别为100%和0%,两组差异有统计学意义(P<0.01)。治疗组2年和3年复发率均明显低于对照组。治疗组2年及3年生存率分别为50.0%及46.0%,而对照组分别为30.0%及24.0%,两组差异有统计学意义(P<0.05)。结论核苷类药物抗病毒治疗对慢乙肝相关性肝癌术后患者能抑制HBV-DNA复制,最大限度的延缓复发,提高患者生存率。

Objective To evaluate the nucleoside anologues antiviral therapy clinical outcome forHBV-related primary hepatic carcinoma patients after hepatectomy. Methods The clinical data wascollected on 100 cases of HBV-related carcinoma after hepatectomy that were selected from March 2010 to March 2014 in the hospital. Out of them, 50 cases were retrospectively analyzed as control grouhepatic transarterial chemoembolization （ TACE） surgery and the other 50 cases as treatment group hadTACE surgery followed by nucleoside analog treatment. Results After two and three years of treatment,the HBV-DNA negativity was 100% and 0% in treatment and control group respectively （P 〈0. 05） ,Furthermore,recurrene rate were decreased in treatment group. The 2 and 3 years of survival rates were50. 0% and 46. 0% in the treatment group and 30. 0% and 24. 0%. in the control group respectively （P 〈 0.05） . Conclusion The nucleoside anti-viral treatment for HBV-related primary hepatic carcinomapatients after hepatectomy effectively inhibits the replication of HBV, uttermostly delays recurrence and improves the patient’s survival rate.