不同类型肝癌患者乙型肝炎病毒、丙型肝炎病毒及肝功能指标的差异及对预后的影响

Differences of hepatitis B virus,hepatitis C virus and liver function indexes in patients with different types of liver cancer and their influence on prognosis

目的探讨不同类型肝癌患者乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)及肝功能指标的差异,并分析其对患者预后的影响。方法将108例原发性肝癌患者根据肝癌类型的不同分为肝细胞癌组53例、胆管细胞癌组35例和混合型肝癌组20例。比较3组患者的HBV、HCV及肝功能指标水平,并分析原发性肝癌患者预后的影响因素。结果胆管细胞癌组和混合型肝癌组患者HBV DNA、HCV RNA高载量率均高于肝细胞癌组患者,差异均有统计学意义(P<0.05)。胆管细胞癌组和混合型肝癌组患者总胆红素(TBIL)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)水平均高于肝细胞癌组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,HBV DNA、HCVRNA高载量和TBIL、AST、ALT高水平均是原发性肝癌患者预后不良的独立危险因素(P<0.05)。结论HBV、HCV及肝功能指标在胆管细胞癌和混合型肝癌患者中的表达水平高于肝细胞癌,并且这些指标对患者的预后具有一定影响。

Objective To investigate the differences of hepatitis B virus(HBV),hepatitis C virus(HCV)and liver function indexes in patients with different types of liver cancer,and to analyze their influence on the prognosis of patients.Method A total of 108 patients with primary liver cancer were divided into hepatocarcinoma group(53 cases),cholangiocarcinoma group(35 cases)and mixed type hepatocarcinoma group(20 cases).The levels of HBV,HCV and liver function indexes in 3 groups were compared,and the influencing factors of prognosis in patients with primary liver cancer were analyzed.Result The high load rates of HBV DNA and HCV RNA in cholangiocarcinoma group and mixed type hepatocarcinoma group were higher than those in hepatocellular carcinoma group,the differences were statistically significant(P<0.05).The levels of total bilirubin(TBIL),aspartate aminotransferase(AST)and alanine aminotransferase(ALT)in cholangiocarcinoma group and mixed type hepatocarcinoma group were higher than those in hepatocellular carcinoma group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that high load of HBV DNA and HCV RNA and high levels of TBIL,AST and ALT were independent risk factors for poor prognosis of patients with primary liver cancer(P<0.05).Conclusion The expression levels of HBV,HCV and liver function indexes in patients with cholangiocarcinoma and mixed type hepatocarcinoma are higher than those in patients with hepatocellular carcinoma,and these indexes have a certain influence on the prognosis of patients.