肝功能失代偿期的乙型肝炎相关肝癌抗病毒治疗的生存分析

目的：探讨肝功能失代偿期的乙型肝炎病毒（HBV）相关肝细胞癌（HCC）患者在介入治疗、射频消融治疗及内科保肝等治疗方案的基础上联合抗HBV治疗的获益情况。方法收集整理近7年来于本院住院治疗的133例肝功能失代偿期的HBV相关HCC患者的病历资料，统计在不同治疗方案下患者的生存情况，运用统计学方法进行生存分析。结果在进行保肝治疗、射频治疗及介入治疗的同时，联合核苷（酸）类似物（NAs）抗病毒治疗的患者生存时间较单独应用上述几种治疗方法的患者生存时间延长：单纯内科保肝治疗的患者中位生存期为4个月，而在单纯内科保肝治疗基础上加用NAs抗病毒治疗者中位生存期为7个月；射频治疗者为8.5个月，射频治疗的同时联合NAs抗病毒者为12个月；介入治疗者中位生存期为7个月，介入治疗的同时加用NAs抗病毒治疗者为13个月。抗病毒治疗组与未抗病毒治疗组生存率差异有统计学意义（内科治疗与内科加抗病毒治疗方案比较，χ^2=7.35，P=0.007；射频治疗与射频加抗病毒治疗方案比较，χ^2=11.78，P=0.001；介入治疗与介入加抗病毒治疗方案比较，χ^2=16.43，P=0.000）。结论给予肝功能失代偿期的HBV相关HCC患者抗病毒治疗能够延长其生存期，可使患者获益。

Survival analysis of HBV-related HCC patients with decompensated liver function and with/without antiviral therapy

Objective To investigate the result of antiviral therapy for those HBV related hepatocellular carcinoma （HCC） patients who were in decompensated liver function and received interventional, radiofrequency ablation and internal medicine hepatoprotective therapies. Methods Total of 133 HBV related HCC patients with decompensated liver function were treated by different treatments in our hospital in the past 7 years. Survival analysis was performed on different treatment groups. Results Patients who received both antiviral therapy and the other therapies at the same time lived longer. Patients who got internal medicine treatment only survived for 4 months;however, patients who received internal medicine treatment plus antivival drugs got 7 months. Patients who were given radiofrequency treatment survived for 8.5 months;while patients got radiofrequency with antiviral drugs treatment survived for 12 months. The interventional therapy group survived for 7 months;and patients who were given intervention and antiviral treatment survived for 13 months. There were statistical differences between antiviral therapy group and no-antiviral therapy group. Internal medicine treatment group compared with internal medicine treatment plus antiviral therapy group （χ^2=7.35, P=0.007）;radiofrequency treatment compared with radiofrequency plus antiviral treatment （χ^2=11.78, P=0.001） and the interventional therapy group compared with interventional therapy plus antiviral therapy （χ^2 = 16.43, P = 0.000） were all with significant differences. Conclusion HBV related HCC patients with decompensated liver function got longer life if they received antiviral therapy.