CAJ | 학술논문

目的：探讨抗病毒治疗对 HBV 相关性肝癌术后的影响。方法回顾性分析113例 HBV 相关性肝癌并行根治性切除患者的病例资料，术后接受抗病毒治疗的为治疗组44例，单纯手术切除的为对照组69例。比较两组1、3、5年无瘤生存率及肝癌复发时肝功能的差异。结果治疗组和对照组的1、3、5年无瘤生存率分别为81．8％、38．6％、26．7％和73．9％、26．5％、13．6％，两组比较差异有统计学意义（P ＝0．038）。至随访终点，共有88例肝癌复发，治疗组（n＝32）相对于对照组（n ＝56）的 ALT、Child-Pugh 评分、HBV DNA 在肝癌复发时明显降低，分别为[（38．2±20．9）U／L 比（48．0±20．3）U／L，P ＝0．046]、[（5．41±0．76）lg 拷贝／mL 比（6．14±1．55）lg 拷贝／mL，P ＝0．014]、[＜2．70 lg 拷贝／mL 比（5．23±1．49）lg 拷贝／mL，P ＜0．01]。结论抗病毒治疗能够改善 HBV 相关性肝癌切除术后的无瘤生存率，并有助于肝癌患者术后残肝功能的恢复，为肝癌复发的综合治疗创造条件。
목적：탐토항병독치료대 HBV 상관성간암술후적영향。방법회고성분석113례 HBV 상관성간암병행근치성절제환자적병례자료，술후접수항병독치료적위치료조44례，단순수술절제적위대조조69례。비교량조1、3、5년무류생존솔급간암복발시간공능적차이。결과치료조화대조조적1、3、5년무류생존솔분별위81．8％、38．6％、26．7％화73．9％、26．5％、13．6％，량조비교차이유통계학의의（P ＝0．038）。지수방종점，공유88례간암복발，치료조（n＝32）상대우대조조（n ＝56）적 ALT、Child-Pugh 평분、HBV DNA 재간암복발시명현강저，분별위[（38．2±20．9）U／L 비（48．0±20．3）U／L，P ＝0．046]、[（5．41±0．76）lg 고패／mL 비（6．14±1．55）lg 고패／mL，P ＝0．014]、[＜2．70 lg 고패／mL 비（5．23±1．49）lg 고패／mL，P ＜0．01]。결론항병독치료능구개선 HBV 상관성간암절제술후적무류생존솔，병유조우간암환자술후잔간공능적회복，위간암복발적종합치료창조조건。
Objective To investigate the effect of antiviral therapy on hepatitis B virus (HBV)-related hepatocellular carcinoma(HCC)after radical hepatectomy.Methods The clinical data of 113 HBV-related HCC patients treated by radical hepatectomy were retrospectively anlyzzed,including 44 treated cases received hepatectomy and antiviral therapy while 69 control cases received hepatectomy only.Disease free survival (DFS)rates at year 1 ,3,5 and liver function at the time of HCC recurrence were compared between the two groups,respectively.Results DFS rates at year 1 ,3 and 5 were 81 .8%, 38.6%,26.7% in treatment group and 73.9%,26.5%,13.6% in control group,respectively(P =0.038).A total of 88 experienced HCC recurrence during the follow-up period.Compared with control group(n=56),levels of ALT [(38.2± 20.9)vs.(48.0±20.3),P =0.046],HBV DNA [(5.41 ±0.76)vs.(6.14±1 .55),P =0.014],and Child-Pugh score [<2.70 vs.(5.23±1 .49)P <0.001]were significantly reduced in treatment group at the time of HCC recurrence.Conclusion Antiviral therapy was associated with a higher DFS among patients with HBV-related HCC after liver resection,and it contributes to improving remnant liver function,thus creating a favorable condition for treatment of recurrent HCC.