Effect analysis of anti hepatitis B virus therapy after resection of hepatocellular carcinoma
10.3877/cma.j.issn.2095-3232.2016.05.005
- VernacularTitle:肝细胞癌切除术后抗HBV治疗疗效分析
- Author:
Jiao GUAN
1
;
Zhengyun ZHANG
;
Zunqiang ZHOU
;
Danian TONG
;
Hao LI
;
Guangwen ZHOU
Author Information
1. 200233上海交通大学附属第六人民医院普通外科
- Keywords:
Carcinoma,hepatocellular;
Hepatitis B virus;
Antiviral agents;
Disease-free survival
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2016;5(5):290-294
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the effect of anti hepatitis B virus (HBV) therapy on patients with HBV associated hepatocellular carcinoma (HCC) after resection.MethodsClinical data of 87 patients with HBV associated HCC after resection treated in Shanghai Jiao Tong University Afifliated Sixth People's Hospital, Afifliated First People's Hospital and Ruijin Hospital, Shanghai Jiaotong University from January 2008 to January 2013 were retrospectively analyzed. There were 40 males and 47 females, 32 cases were<55 years old and 55 cases were≥55 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. According to the tumor diameter, the patients were divided into the tumor diameter≤3 cm group (n=36) and>3 cm group (n=51). According to whether the patients had received anti HBV therapy, each group was divided into anti HBV subgroup and non-anti HBV subgroup. Patients with anti HBV therapy began to receive treatment of entecavir 14 d after operation. The changes of alanine aminotransferase (ALT) and inhibition rate of hepatitis B virus-deoxyribonucleic acid (HBV-DNA) 6 months after operation were observed in each group. The ALT and inhibition rate of HBV-DNA were compared usingt test, survival analysis was conducted using Kaplan-Meier method and Log-rank test, and influencing factors analysis was conducted using Cox proportional hazard regression model.ResultsIn the tumor diameter≤3 cm group, the inhibition rate of HBV-DNA in the anti HBV subgroup was (47±6) %, which was higher than (9±3) % in the non-anti HBV subgroup (t=3.142,P<0.05). And in the anti HBV subgroup, the ALT level decreased from (46±10) U/L before treatment to (34±8) U/L after treatment, where signiifcant difference was observed (t=-2.339, P<0.05). In the tumor diameter≤3 cm group, the median of disease-free survival (DFS) time of the patients in the anti HBV subgroup was 48 months, and was 35 months in the non-anti HBV subgroup, and signiifcant difference was observed between two groups (χ2=13.09,P<0.05). Anti HBV therapy after operation and serum alpha-fetoprotein (AFP) level>400 μg/L were the independent factors for the DFS of patients with tumor diameter≤3 cm (OR=0.220, 2.657;P<0.05). ConclusionsPostoperative anti HBV therapy is an independent inlfuencing factor for the DFS of patients with small HCC. Anti HBV therapy can raise the survival rate by improving the residual liver function of patients.
