HBV-DNA载量影响甲磺酸阿帕替尼治疗晚期乙肝相关性肝细胞癌的疗效及预后分析

Effect of HBV-DNA copy level on therapeutic efficacy of apatinib mesylate and prognosis of advanced hepatitis B related hepatocellular carcinoma

目的 研究HBV-DNA载量对甲磺酸阿帕替尼治疗晚期乙肝相关性肝细胞癌(HBV-HCC)的疗效及预后影响。方法 回顾性收集2015-06-10-2021-12-31在河北医科大学第四医院接受甲磺酸阿帕替尼治疗的HBV-HCC患者40例资料。根据HBV-DNA载量,将HBV-HCC患者分为HBV-DNA低载量组(26例)与HBV-DNA高载量组(14例)。观察不同HBV-DNA载量患者的临床特征、阿帕替尼疗效及生存期方面的差异,随访截至2022-04-08。采用Kaplan-Meier法进行单因素生存分析,Cox回归模型进行多因素分析。结果 经阿帕替尼治疗的HBV-DNA低载量组和高载量组疾病控制率分别为61.5%(16/26)和21.4%(3/14),差异有统计学意义,χ^(2)=5.871,P=0.015。生存分析发现,HBV-DNA低载量组的无进展生存期(HR=9.227,95%CI:2.689~31.663,P<0.001)及总生存期(HR=5.352,95%CI:1.592~17.992,P=0.007)优于高载量组,差异均有统计学意义。结论 HBV-DNA载量影响阿帕替尼治疗晚期HBV-HCC的效果,HBV-DNA载量可作为HBV-HCC患者预后的独立影响因素。

Objective To evaluate the effect of hepatitis B virus(HBV) cope level on therapeutic efficacy of apatinib mesylate and prognosis of advanced HBV related hepatocellular carcinoma(HBV-HCC).Methods Totally 40 cases of HBV-HCC patients treated with apatinib mesylate at The Fourth Hospital of Hebei Medical University from June 10,2015 to December 31,2021 were involved.According to the HBV-DNA copy levels, the HBV-HCC patients were divided into HBV-DNA low copy group(26 cases) and HBV-DNA high copy group(14 cases).The clinical characteristics, therapeutic effect of apatinib mesylate and survival rate of patients with different HBV copy levels were observed.The enrolled patients were followed up until April 8,2022.Kaplan Meier method was used for univariate survival analysis, and Cox regression model was used for multivariate analysis.Results The disease control rates of HBV-DNA low copy and HBV-DNA high copy groups treated with apatinib were 61.5%(16/26) and 21.4%(3/14),respectively, indicating a statistically significant difference, χ^(2)=5.871,P=0.015.Survival analysis indicated that the progression free survival(HR=9.227,95%CI:2.689-31.663,P<0.001) and overall survival(HR=5.352,95%CI:1.592-17.992,P=0.007) of the HBV-DNA low copy group were significantly different from those of the HBV-DNA high copy group.Conclusions HBV-DNA copy level affected the efficacy of apatinib mesylate in the treatment of advanced HBV-HCC.HBV-DNA copy level could be used as the independent risk factor that was correlated with the prognosis of HBV-HCC patients.