摘要
目的对于血清乙型肝炎病毒（hepatitisBvirus，HBV）DNA阴性的中晚期乙肝相关肝细胞癌（hepatitis B vi-rus related hepatocellular carcinoma,HBVR-HCC）患者，行肝动脉化疗栓塞（transarterial chemoembolization, TACE）后是否应行抗病毒治疗尚缺乏相关临床资料。本研究拟观察恩替卡韦抗病毒治疗对血清HBVDNA阴性的HBVR-HCC患者TACE术后的影响。方法选取2012-05—01—2014—05—01在武警上海市总队医院行TACE术HBVR-HCC患者80例（血清HBVDNA〈500IU／mL），随机数字表法分为观察组（TACE联合恩替卡韦）40例和对照组（仅行TACE治疗）40例。比较2组患者治疗前后肝功能、凝血功能、甲胎蛋白（alpha—fetoprotein，AFP）、Child—pugh评分变化情况及生存状况。结果术后72及96周，观察组凝血酶原时间（prothrombintime，PT）与AFP明显低于对照组，差异有统计学意义，P〈0．05。观察组和对照组客观缓解率（objectiveresponserate，0RR）分别为52．5％和50．0％，差异无统计学意义，χ2=0．050，P=0．823；疾病控制率（diseasecontrolrate，DCR）分别为82．5％和85．0％，差异无统计学意义,χ2=0．092，P：0．762。观察组与对照组1年生存率分别为80．0％和70．0％，差异无统计学意义，χ2=1．067，P=0．617；2年生存率分别为75．0％和52．5％，差异有统计学意义，χ2=4．381，P=0．036。观察组与对照组中位生存期（medianoverallsurvival，mOS）分别为26．0C95％可信区间（confidenceinterval，CI）为23．9～28．1]与22．9（95％CI为6．2～39．6）个月，差异有统计学意义，χ2=4．793，P=0．029；中住疾病无进展生存期（medianprogression-freesurvival，mPFS）分别为16．2（95％CI为14．8～17．6）与15．3（95％CI为4．6～26．0）个月，差异有统计学意义，χ2=4．387，P=0．036。结论血清HBVDNA阴性的HBVR-HCC患者TACE术后行抗病毒治疗可能对延长患者生存时间和改善预后有益。
OBJECTIVE Whether patients with hepatitis B virus （HBV） DNA negative HBV related hepatocellular carcinoma （HBVR-HCC） should take antiviral therapy after transarterial chemoembolization （TACE） remains unclear. This study planed to observe the effect of entecavir in treatment of HBV DNA negative HBVR-HCC after TACE. METHODS Eighty patients with HBVR-HCC （serum HBV DNA〈500 IU/mL） were collected during the period of 2012-5-1-2014-5-1 from shanghai corps hospital of Chinese People＇s Armed Police Forces, randomly assigned into treat- ment group （n= 40, TACE＋ entecavir） and control group （n = 40, TACE alone）. The liver function, coagulation func- tion,-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 prothrombin time （PT） and AFP was significantly lower in treatment group than that in control group at 72 and 96 weeks（P〈0.05）. The objective response rate （ORR） and dis- ease control rate （DCR） had no significant difference between the treatment groups and control groups, there were52.5 % vs 50.0% （χ2=0.050,P〈0.823） and 82.5% vs 85.0% （χ2=0. 092,P=0. 762） ,respectively. The survival rate of the treatment groups and control groups had no statistically significant difference at 1 year after TACE （80.0% vs 70.0%,χ2 =1. 067,P〈0. 617） ,while had statistical difference at 2 years （75.0%vs 52.5% ,χ2 =4. 381,P=0. 036）. The median overall survival （mOS） and median progression-free survival （mPFS） of the treatment groups and control groups had sta- tistical significance,there were 26.0 （95%CI： 23.9,28.1） months VS. 22.9 （95%CI： 6.2,39.6） months （χ2 =4. 793, P=0.029） and 16.2 （95%CI：14. 8,17. 6） monthsvs 15.3 （95%CI：4.6,26.0） months （χ2=4.387,P=0.036）,respec tively. CONCLUSION Antiviral treatment of HBV DNA negative HBVR-HCC after TACE could prolong survival and improve prognosis.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2016年第1期25-29,共5页
Chinese Journal of Cancer Prevention and Treatment
关键词
乙型肝炎
肝细胞癌
抗病毒
动脉化疗栓塞
hepatitis B
hpatocellular carcinoma
antiviral
transarterial chemoembolization
