肝动脉化疗栓塞对原发性肝癌患者HBV DNA水平的影响

背景与目的：化疗可抑制恶性肿瘤患者的免疫功能，导致合并乙型肝炎病毒（hepatitis B virus，HBV）感染的肿瘤患者出现HBV激活，严重影响了患者的预后。本研究旨存了解肝癌患者肝动脉化疗栓塞（trans catheter arterial ehemoembolization，TACE）前后乙型肝炎病毒脱氧核糖核酸（HBVDNA）含量的变化及其影响凶素。方法：回顾性分析2004年12月至2008年7月期间，162例肝癌患者TACE治疗前后HBVDNA的变化．并分析HBVDNA变化与AFP的关系。结果：治疗后HBVDNA阳性率较治疗前显著降低『55．6％VS．71．6％，P〈0．01]。治疗前HBVDNA≥ 1×10^5／L者更易出现HBVDNA水平的下降（OR=2．7，P〈0．01）；治疗后AFP的下降与HBVDNA下降有关联（OR=2．6，P〈O．05）。结论：TACE能降低HBV相关的肝癌患者体内的HBVDNA水平，特别是治疗前HBVDNA≥ 1×10^5／L者及治疗后AFP降低者。

Effect of transcatheter arterial chemoembolization on HBV DNA level in primary liver cancer patients

Background and Objective. Systemic chemotherapy would suppress the immune system and cause reactivation of hepatitis B virus （HBV） in the tumor patients with HBV infection, which seriously affect the prognosis. Our study was to investigate the effect of transcatheter arterial chemoembolization （TACE） on HBV DNA level in primary liver cancer patients, and explore related factors. Methods- Clinical data of 162 patients with primary liver cancer who underwent TACE from December 2004 to July 2008 were analyzed. All patients＇ HBV DNA level, alpha-fetoprotein （AFP） and liver function before and after TACE were evaluated, Correlation of HBV DNA alteration to AFP was analyzed. Results： The positive rate of HBV DNA was decreased significantly after TACE （55.6% vs. 71.6%, P〈0.01）. HBV DNA level was inclined to decease after TACE in the patients with HBV DNA of ≥ 1×10^5/mL （odds ratio = 2.7, P〈0.01）. The decrease of HBV DNA was also related with the decrease of AFP level （odds ratio = 2.6,P〈0.05）. Conclusion.TACE can decrease HBV DNA level in primary liver cancer patients, especially for those with preoperative HBV DNA level of ≥ 1×10^5/ mL and those with postoperative AFP decline.