根治性肝切除术后抗病毒治疗对HBV相关性肝细胞癌患者预后的影响

Effect of antiviral therapy following radical hepatectomy on prognosis in patients with hepatitis B virus-related hepatocellular carcinoma

目的探讨根治性肝切除术后抗病毒治疗对HBV相关性肝细胞癌患者预后的影响。方法选择行根治性肝切除术后的HBV相关性肝细胞癌患者130例,采用随机数字表法分为观察组63例和对照组67例。对照组术后给予常规治疗,观察组术后给予恩替卡韦分散片抗病毒治疗。对比两组患者的无瘤生存、总生存及复发情况,并分析无瘤生存及总生存的影响因素。结果两组患者术后1年、术后3年无瘤生存率、无瘤生存时间及术后1年总生存率比较,差异均无统计学意义(均P>0.05);但观察组术后3年总生存率高于对照组,总生存时间长于对照组,3年复发率低于对照组(P<0.05)。性别、抗病毒治疗、术前HBV-DNA水平、HBe Ag水平、镜下微血管癌栓、肝硬化均是影响无瘤生存和总生存的独立因素(均P<0.05)。结论根治性肝切除术后给予抗病毒治疗可提高HBV相关性肝细胞癌患者的生存率,降低其复发风险。

Objective To investigate the effect of antiviral therapy following radical hepatectomy on the prognosis of patients with hepatitis B virus-related hepatocellular carcinoma（ HCC）. Methods A total of 130 patients with hepatitis B virus-related HCC undergoing radical hepatectomy were divided into observation group（ 63 cases） and control group（ 67 cases） according to the random number table method. The control group was given conventional treatment after operation,while the observation group was given the antiviral therapy with Entecavir Dispersible Tablets after operation. The disease-free survival,overall survival and recurrence were compared between the two groups,and the influencing factors of disease-free survival and overall survival were analyzed. Results No significant differences were found in the postoperative 1-or 3-year disease-free survival,disease-free survival time or postoperative 1-year overall survival between the two groups（ P〉 0. 05）; the observation group obtained higher postoperative 3-year overall survival,higher overall survival and lower postoperative 3-year recurrence rate compared to the control group（ P〈 0. 05）. Gender,antiviral treatment,preoperative levels of HBV-DNA and HBe Ag,microscopic vascular tumor thrombus,and liver cirrhosis were the independent factors affecting disease-free survival and overall survival（ P〈 0. 05）. Conclusion Antiviral therapy following radical hepatectomy can increase the survival rate and reduce the risk of recurrence in patients with hepatitis B virus-related related HCC.