抗病毒治疗在伴高滴度HBV-DNA原发性肝癌术后复发中的作用
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A study of antiviral therapy in prevention of tumor recurrence after radical liver resection of hepatocellular carcinoma with high load of hepatitis B virus DNA
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    目的:评价拉米夫定抗病毒治疗伴高滴度HBV-DNA肝细胞性肝癌(hepatocellular carcinoma, HCC)术后的临床疗效-方法:93例伴高滴度HBV-DNA HCC术后患者随机分治疗组与对照组-43例对照组采用单纯手术切除,50例治疗组采用口服拉米夫定(LAM) 100 mg/d-采用SPSS13.0软件进行统计分析,Kaplan-Meier法计算无瘤生存率,Log-rank法进行组间差异分析-结果:所有病例均获随访,期间肿瘤复发73例(78.49%),死亡65例(69.89%)-单纯手术切除组和手术切除联合抗病毒治疗组1-3-5年的无瘤存活率分别为:76.74%-44.19%-13.95%和88.25%-69.78%-28.73%,两组之间差异有统计学意义(P = 0.014 3)-结论:肝癌根治术后抗病毒治疗能降低肿瘤复发率, 对术前 HBV-DNA高水平复制肝癌患者,宜尽早联合抗病毒治疗-

    Abstract:

    Objective:To evaluate the effects of antiviral therapy in prevention of tumor recurrence after curative treatment for patients with hepatocellular carcinoma (HCC). Methods: Between Aug 2003 and Aug 2008, 93 patients undergoing radical liver resection for HCC were enrolled in the retrospective analysis. Patients were assigned to two groups: 43 cases of patients(serum HBV-DNA ≥1.0×105 copies/ml) without lamivudine antiviral therapy after operation and 50 cases of patients(serum HBV-DNA ≥1.0×105 copies/ml) received lamivudine(100 mg/d) antiviral therapy after operation. The Kaplan-Meier method was used to calculate the tumor-free survival rates, Log-rank test was performed to evaluate the difference between two groups. Results: All patients were followed-up, the overall recurrence rate and mortality were 78.49%(73 cases ) and 69.89%(65 cases). The 1,3,5-year recurrence rate was 76.74%, 44.19%, 13.95% in radical liver resection group without antiviral therapy and 88.25%, 69.78%, 28.73% in radical liver resection group received lamividine antiviral therapy(P = 0.014 3). Conclusion: The study suggested that antiviral therapy after radical liver resection in patients with HCC can reduce the tumor recurrence and those patients with HBV-DNA ≥1.0×105 copies/ml should received an antiviral therapy as early as possible after extirpation of the primary tumor.

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成 峰,吕 凌,孙倍成,李国强,李相成,张 峰,王学浩.抗病毒治疗在伴高滴度HBV-DNA原发性肝癌术后复发中的作用[J].南京医科大学学报(自然科学版),2011,(6):882-884

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  • 收稿日期:2011-04-24
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