摘要
目的:探讨HBV DNA载量水平对乙型肝炎相关原发性肝癌(HBV-HCC)预后情况的影响,及HBV DNA载量与各指标之间的相关性。方法:回顾性收集2019年2月1日至2021年10月30日于河南中医药大学第一附属医院脾胃肝胆科住院的HBV-HCC患者的基本信息(性别、年龄、生存期等)、HBV DNA载量、乙型肝炎病毒标志物定量、肝功能、肿瘤标记物、肿瘤分期等信息,分析HBV DNA载量水平与BCLC分期、乙型肝炎病毒标志物、肝功能、肿瘤标记物的相关性,探讨病毒载量水平对HBV-HCC复发及生存的影响并进行K-M生存分析。结果:纳入的207例病例中,不同病毒载量之间总生存期差异有统计学意义(χ~2=37.609,P<0.05),且阴性组较阳性组、低病毒载量组较高病毒载量组中位生存时间均更长(P<0.05);相关性分析发现病毒载量与BCLC分期、HBsAg分级、HBeAg定性、HBcAb定性、TBil、AST、ALT、ALP、AFP、CA199、CA125均呈正相关(P<0.05),与Alb、A/G呈负相关(P<0.05);生存分析发现,HBV DNA载量水平是影响HBV-HCC患者无进展生存期及总生存期的独立预后因素(Log-rankχ~2=17.928,P=0.000;Log-rankχ~2=38.865,P=0.000),其中高病毒载量组复发及死亡的风险均增加,是影响预后的独立危险因素(HR=3.053,95%CI=1.840~5.067,P=0.000;HR=12.051,95%CI=4.905~29.603,P=0.000)。结论:HBV DNA载量水平与HBV-HCC患者肿瘤分期、乙型肝炎病毒标志物、肝功能指标、肿瘤标记物之间存在相关性,HBV DNA载量水平是HBV-HCC患者无进展生存期和总生存期的影响因素,高病毒载量是影响其预后的独立危险因素。
Objective:To explore the influence of the level of HBV DNA load on the prognosis of hepatitis B associated Hepatocellular carcinoma(HBV-HCC),and the correlation between the viral load and various indicators.Methods:Retrospectively collect basic information of HBV-HCC patients who were hospitalized in the First Affiliated Hospital of Henan University of Chinese Medicine from 1 February 2019 to 30 October 2021.The information includes the basic information of the patient(gender,age,survival period,etc.),HBV DNA load,the five quantitative items of hepatitis B,liver function,tumor markers,tumor stage,etc.The correlation between HBV DNA load level and BCLC stage,hepatitis B virus markers,liver function and tumor markers was analyzed.The effects of HBV DNA load level on HBV-HCC recurrence and survival were investigated,and K-M survival analysis was performed.Results:In the 207 cases,the difference of overall survival time between different viral loads was statistically significant(χ2=12.478,P<0.05),and the median survival time of the negative group was longer than that of the positive group and the low load group was longer than that of the high load group(P<0.05).Correlation analysis showed that viral load was positively correlated with BCLC stage,HBsAg grade,HBeAg characterization,HBcAb characterization,TBil,AST,ALT,ALP,AFP,CA199,CA125(P<0.05),and negatively correlated with Alb and A/G(P<0.05).Survival analysis showed that the level of HBV DNA load was an independent prognostic factor affecting progression free survival and overall survival of HCC patients(Log-rankχ2=17.928,P=0.000;Log-rankχ2=38.865,P=0.000).The risk of recurrence and death increased in the high load group,and high viral load was an independent risk factor affecting the prognosis(HR=3.053,95%CI=1.840-5.067,P=0.000;HR=12.051,95%CI=4.905-29.603,P=0.000).Conclusion:The level of HBV DNA load is correlated with tumor stage,five items of hepatitis B,liver function indexes and tumor markers of HCC patients.The level of HBV DNA load is an influencing factor for progression free survival and total survival of HBV-HCC patients,and high viral load is an independent risk factor for prognosis.
作者
谢露
刘光伟
郭会军
XIE Lu;LIU Guang-wei;GUO Hui-jun(Henan University of Traditional Chinese Medicine,Zhengzhou Henan,450000,China)
出处
《中西医结合肝病杂志》
CAS
2023年第10期925-929,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
国家自然科学基金项目(No.82274474,81873187)
中原领军人才项目(No.ZYYCYU202012119)。
