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术前乙型肝炎病毒感染状态与原发性肝癌预后的相关性分析

Association between preoperative infection status of hepatitis B virus and prognosis of primary liver cancer

  • 摘要:
    目的 探讨术前乙型肝炎病毒(hepatitis B virus,HBV)感染状态与肝癌切除术后预后的关系。
    方法 选择2014年7月至2015年6月复旦大学附属中山医院收治的行根治性切除的肝细胞癌患者910例,收集术前乙肝两对半和HBV-DNA的结果,结合临床病理信息和随访资料,阐明肝癌患者乙肝感染状态和其对患者预后的影响。
    结果 95.1%的肝癌手术患者存在乙型肝炎病毒感染,其中以"小三阳"者最为多见,占54.2%。HBV-DNA的阳性患者术后无瘤生存率及总生存率显著低于阴性患者(P < 0.05)。HBV-DNA阳性组和阴性组的肝硬化程度、甲胎蛋白(alpha-fetoprotein,AFP)水平、肿瘤大小以及血管侵犯差异均有统计学意义(P < 0.001)。
    结论 完善乙肝血清学标志物的检测,有利于肝癌的防治以及改善患者预后。

     

    Abstract:
    Objective Hepatitis B virus (HBV) infection is a risk factor for primary liver cancer. This article aims to explore the relationship between the preoperative HBV infection status and the prognosis after liver cancer resection.
    Methods Totally, 910 patients with hepatocellular carcinoma undergoing radical resection were randomly selected. Clinicopathological information, preoperative hepatitis B marker serological examination, and follow-up data were used to analyze the relationship between preoperative hepatitis B infection status and patient prognosis.
    Results 95.1% of patients undergoing surgery for liver cancer had hepatitis B virus infection, of whom the "small three positives" were the most common, accounting for 57.0%. The postoperative tumor-free survival rate and overall survival rate of HBV-DNA-positive patients were significantly lower than those of negative patients (P < 0.05). HBV-DNA was positively correlated with liver cirrhosis, alpha-fetoprotein level, tumor size, and vascular invasion (P < 0.001).
    Conclusions Enhancing the detection of hepatitis B serum markers is beneficial for the prevention and treatment of liver cancer and could improve patient prognosis.

     

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