CAJ | 학술논문

目的：分析小肝癌合并HBV与HCV感染的临床病理因素间差别，探讨乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）感染对小肝癌的外科治疗策略及预后的影响。方法回顾性分析2006年1月至2012年12月间天津医科大学附属肿瘤医院413例行手术根治切除治疗的小肝癌（≤3cm）患者的临床资料，将其分为四组：HCV感染组（n＝75）、HBV感染组（n＝251）、HCV＋HBV感染组（n＝33）和无感染组（n＝54）、对其预后影响因素进行统计分析。结果相比较其他组而言，HCV感染组年龄偏大、术前血小板水平及白蛋白低，凝血酶原时间长，丙氨酸转氨酶及总胆红素高，并且HCV感染组诊断时多结节型比例较高。和其他组相比，HCV感染组肝硬化程度严重，肿瘤细胞分化低，更易发生血管侵犯。在随访过程中，HCV感染组肝内复发率高，且复发类型常为多结节型。结论小肝癌合并HCV感染患者在诊断时往往肝硬化严重并且多结节型肝癌常见。预后统计分析发现影响小肝癌预后的因素为：HCV感染、血管侵犯和肿瘤多发。
목적：분석소간암합병HBV여HCV감염적림상병리인소간차별，탐토을형간염병독（HBV）、병형간염병독（HCV）감염대소간암적외과치료책략급예후적영향。방법회고성분석2006년1월지2012년12월간천진의과대학부속종류의원413례행수술근치절제치료적소간암（≤3cm）환자적림상자료，장기분위사조：HCV감염조（n＝75）、HBV감염조（n＝251）、HCV＋HBV감염조（n＝33）화무감염조（n＝54）、대기예후영향인소진행통계분석。결과상비교기타조이언，HCV감염조년령편대、술전혈소판수평급백단백저，응혈매원시간장，병안산전안매급총담홍소고，병차HCV감염조진단시다결절형비례교고。화기타조상비，HCV감염조간경화정도엄중，종류세포분화저，경역발생혈관침범。재수방과정중，HCV감염조간내복발솔고，차복발류형상위다결절형。결론소간암합병HCV감염환자재진단시왕왕간경화엄중병차다결절형간암상견。예후통계분석발현영향소간암예후적인소위：HCV감염、혈관침범화종류다발。
Objective To determine if differences exist in preoperative characteristics and postoperative HCC recurrence in patients with different HBV and HCV infection status. Methods The study population consisted of 413 patients undergoing a curative resection at Tianjin Cancer Hospital for small HCC ( ≤ 3cm) from January 2006 to December 2012. The patients were divided into four groups:HCV only (n=75), HBV only (n=251), HBV and HCV (n=33), and neither HBV nor HCV (NBNC, n=54). The preoperative status and postoperative HCC recurrence were recorded. Survival analyses were used to assess the impact of HBV/HCV status on HCC recurrence. Results Patients with HCV had a significant association with older age, lower mean preoperative platelet counts and albumin levels, higher mean prothrombin time, alanine aminotransferase and total bilirubin levels and multinodular tumors during diagnosis. Patients with HCV also had significantly less differentiated tumors and a higher incidence of vascular invasion and cirrhosis when compared to the other groups. During the follow-up, the HCV group showed a higher incidence of intrahepatic recurrence and multiple recurrent lesions than the other patients. Conclusions Patients with HCV infection tended to be older and were characterized by more severe cirrhosis and higher incidence of tumor multicentricity. The statistically significant determinants for recurrence in patients with small HCC were HCV infection, presence of vascular invasion and multiple tumors..