术前乙型肝炎病毒感染状态与原发性肝癌预后的相关性分析

目的： 探讨术前乙型肝炎病毒（hepatitis B virus,HBV）感染状态与肝癌切除术后预后的关系。方法： 选择2014年7月至2015年6月复旦大学附属中山医院收治的行根治性切除的肝细胞癌患者910例,收集术前乙肝两对半和HBV-DNA的结果,结合临床病理信息和随访资料,阐明肝癌患者乙肝感染状态和其对患者预后的影响。结果： 95.1%的肝癌手术患者存在乙型肝炎病毒感染,其中以"小三阳"者最为多见,占54.2%。HBV-DNA的阳性患者术后无瘤生存率及总生存率显著低于阴性患者（P<0.05）。HBV-DNA阳性组和阴性组的肝硬化程度、甲胎蛋白（alpha-fetoprotein,AFP）水平、肿瘤大小以及血管侵犯差异均有统计学意义（P<0.001）。结论： 完善乙肝血清学标志物的检测,有利于肝癌的防治以及改善患者预后。

Association between preoperative infection status of hepatitis B virus and prognosis of primary liver cancer

Objective: Hepatitis B virus (HBV) infection is a risk factor for primary liver cancer. This article aims to explore the relationship between the preoperative HBV infection status and the prognosis after liver cancer resection. Methods: Totally, 910 patients with hepatocellular carcinoma undergoing radical resection were randomly selected. Clinicopathological information, preoperative hepatitis B marker serological examination, and follow-up data were used to analyze the relationship between preoperative hepatitis B infection status and patient prognosis. Results: 95.1% of patients undergoing surgery for liver cancer had hepatitis B virus infection, of whom the "small three positives" were the most common, accounting for 57.0%. The postoperative tumor-free survival rate and overall survival rate of HBV-DNA-positive patients were significantly lower than those of negative patients (P<0.05). HBV-DNA was positively correlated with liver cirrhosis, alpha-fetoprotein level, tumor size, and vascular invasion (P<0.001). Conclusions: Enhancing the detection of hepatitis B serum markers is beneficial for the prevention and treatment of liver cancer and could improve patient prognosis.