对比乙型与丙型肝炎背景下肝细胞癌患者经微波消融治疗后预后

目的 对比观察微波消融（MWA）治疗乙型（HB）与丙型肝炎（HC）背景下肝细胞癌（HCC）的预后。方法 回顾性分析HCC伴HB（HB-HCC）及HCC伴HC（HC-HCC）各159例患者资料，比较组间肿瘤学结局，分析患者死因，观察HCC患者MWA后总生存期（OS）的危险因素。结果 HC-HCC组OS率低于HB-HCC组（P=0.045），组间无病生存率（P=0.095）及癌症特异性生存率（P=0.189）差异均无统计学意义。相比HB-HCC组，HC-HCC组患者死于肝硬化并发症的风险更高（HR=2.339，P=0.043）。Child-Pugh B级（HR=3.082，P＜0.001）、肝炎病毒载量＞500 IU/ml（HR=1.654，P=0.006）及病灶最大径≥3.0 cm（HR=1.541，P=0.017）均为HCC患者MWA后OS的独立危险因素。结论 相比HB-HCC患者，HC-HCC患者MWA后OS较短。

Comparison on prognosis of hepatocellular carcinoma patients with hepatitis B and hepatitis C after microwave ablation

Objective To comparatively explore the prognosis of hepatocellular carcinoma (HCC) patients with hepatitis B (HB) and hepatitis C (HC) after microwave ablation (MWA). Methods Data of 159 HCC patients with HB (HB-HCC) and 159 HCC patients with HC (HC-HCC) who received MWA treatment were retrospectively collected. The oncologic outcomes were compared between groups, the causes of death were analyzed, and the risk factors of overall survival (OS) in HCC patients after MWA were observed. Results The OS rate in HC-HCC group was lower than that in HB-HCC group (P=0.045), while no significant difference of disease free survival rate (P=0.095) nor cancer specific survival rate (P=0.180) was found between groups. Compared with HB-HCC group, HC-HCC group had higher risk of death due to complications related to liver cirrhosis (HR=2.339, P=0.043). Child-Pugh class B (HR=3.082, P<0.001), hepatitis viral load>500 IU/ml (HR=1.654, P=0.006) and the maximum diameter of lesion ≥ 3.0 cm (HR=1.541, P=0.017) were all independent risk factors of OS in HCC patients after MWA. Conclusion Compared with HB-HCC patients, HC-HCC patients had shorter OS after MWA.