抗病毒治疗对HBV DNA阴性的乙肝相关肝癌行TACE术后HBV再激活的预防及对预后影响

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Abstract Objective To study plan to observe the effect of antiviral therapy on hepatitis B virus (HBV) DNA negative HBV related hepatocellular carcinoma(HBVR-HCC), prevention of HBV reactivation and prognosis after transarterial chemoembolisation.Methods Sixty patients with HBVR-HCC (serum HBV DNA<500 IU/ml) were recruited during the period of 2012-05-01~2014-05-01 from Shanghai Corps Hospital of Chinese Pepole’s Armed Police Force, randomly assigned into study group (n=30, antiviral before TACE) and control group (n=30, TACE alone, antiviral unless HBV reactivation). The serum HBV DNA, liver function, coagulation function, α-fetoprotein (APF), and Child-Pugh score of the two groups before and after treatment were analyzed, and survival status between the two groups were compared.Results The characteristics of the two groups had no statistically significant differentce in the baseline. No HBV reactivation was found in the study group, while six were found in control group, there was statistically significant difference between the two group(χ²=6.486,P=0.011).During the follow-up for two years, the liver function and Child-Pugh score had no statistical significant difference between the two groups. Prothrombin time (PT) and AFP had no statistically significant difference between the two groups at 24 and 48 weeks after TACE(P>0.05), while in the study group were significantly lower than in the control group at 72 and 96 weeks(P<0.05). The Objective response rate (ORR) and disease control rate (DCR) had no statistically significant difference between the study group and the control group, there were 56.7% vs 50.0% (χ²=0.268,P=0.605) and 86.7% vs 83.3% (χ²=0.131,P=0.718), respectively. The survival rate of in the study group and the control group had no statistically significant difference at 1 year after TACE (76.7% vs 70.0%, χ²=0.341,P=0.559), while had statistically significant difference at 2 years (70.0% vs 43.3%,χ²=4.344, P=0.037). The median overall survival (mos) and median progression-free survival (mpfs) in the study group and the control group had statistically significant difference, there were 26.1 (95%CI: 23.9-28.1 ) months vs 22.7 (95%CI: 6.2-39.6) months (χ²=4.857,P=0.021) and 16.4 (95%CI:14.8-17.6) months vs 15.1 (95%CI:4.6-26.0)months (χ²=4.651,P=0.027), respectively.Conclusions Antiviral therapy of HBV DNA negative HBVR-HCC before TACE can prevent HBV reactivation, prolong survival and improve prognosis.

Key words： hepatitis B reactivation hepatocellular carcinoma antiviral transarterial chemoembolization

Received: 24 November 2015

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	Articles by authors
	YANG Yang
	YANG Long
	WEI Yan
	JIANG Xuehua
	CHEN Zhiyong
	and CHEN Jian

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YANG Yang,YANG Long,WEI Yan等. Effect of antiviral therapy on prevention ofHBV reactivation after transarterial chemoembolization and prognosis in patients with of HBV DNA negative HBV related hepatocellular carcinoma[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2016, 27(4): 329-333.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2016/V27/I4/329

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