TACE术后接受恩替卡韦治疗血清HBV DNA阴性的中晚期原发性肝癌患者生存率研究

doi:10.3969/j.issn.1672-5069.2018.01.024

摘要/Abstract

摘要： 目的观察抗病毒治疗对血清HBV DNA阴性的中晚期肝癌患者中远期生存率的影响。方法 82例血清HBV DNA阴性的中晚期肝癌患者,采用随机数字表法分为观察组41例和对照组41例。在对照组,行经肝动脉栓塞化疗（TACE）治疗,观察组在TACE术基础上联合恩替卡韦进行抗病毒治疗。比较两组客观缓解率、疾病控制率、治疗48周和96周肝功能指标、2 a和3 a疾病无进展生存（PFS）和总生存（OS）时间。结果术后8周,观察组和对照组客观缓解率分别为53.6%和50.3%,疾病控制率分别为82.9%和85.5% （均P>0.05）;两组治疗前后血清TBIL、ALT、INR、AFP水平差异均无统计学意义（P>0.05）;观察组3 a DFS和OS分别为61.0%和73.2%,显著高于对照组的36.6%和51.2% （P<0.05）;观察组血清HBV DNA转阳率为2.4%,显著低于对照组的19.5%（P<0.05）。结论血清HBV DNA阴性的中晚期肝癌患者在TACE术后应用恩替卡韦进行抗病毒治疗可提高生存率,避免HBV DNA转阳,使患者远期获益。

关键词: 原发性肝癌, HBV DNA, 经肝动脉栓塞化疗, 恩替卡韦, 生存

Abstract: Objective To observe the efficacy of enticavir on long-term survival in patients with serum HBV DNA negative hepatitis B-induced primary liver cancer（PLC） after transcatheter arterial chemoembolization （TACE）. Methods 82 patients with advanced HBV-related PLC were recruited and divided into observation group and control group,with 41 cases in each group. The patients in control group was treated with TACE,and the patients in observation group was treated with entecavir for antiviral therapy after TACE. The Objective remission rate,disease control rate,serum liver function index after 48 weeks and 96 weeks,the progression-free survival （PFS） and overall survival （OS） at 2 years and 3 years,and serum HBV DNA positive rate during follow-up were compared between the two groups. Results The objective remission rates in observation group and in control group were 53.6% and 50.3%,respectively,and the disease control rates were 82.9% and 85.5%,respectively（P>0.05）;there were no significant differences as respect to serum levels of liver function index and serum fetoprotein between the two groups before and after the treatment （P>0.05）;the DFS rate and OS rate at 3-year were 61.0% and 73.2% in the observation group, much higher than those in the control group （36.6% and 51.2% respectively,P<0.05）;the positive rate of serum HBV DNA in the observation group was 2.4%,much lower than that in the control group（19.5%,P<0.05）. Conclusion The application of entecavir for antiviral treatment can improve the survival rate and avoid HBV DNA back to positivity,so that benefits the PLC patients with serum HBV DNA negative after TACE.

Key words: Hepatoma, HBV DNA, Transcatheter arterial chemoembolization, Enticavir, Long-term survival

张世同, 金建军, 白艳丽, 吴利娟. TACE术后接受恩替卡韦治疗血清HBV DNA阴性的中晚期原发性肝癌患者生存率研究[J]. 实用肝脏病杂志, 2018, 21(1): 100-103.

Zhang Shitong, Jin Jianjun, Bai Yanli, et al. Efficacy of enticavir on long-term survival in patients with serum HBV DNA negative hepatitis B-induced primary liver cancer after TACE[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2018, 21(1): 100-103.

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