中国实用外科杂志

中国实用外科杂志 ›› 2012, Vol. 32 ›› Issue (10): 811-814.

• 专题笔谈 • 上一篇    下一篇

HBV相关肝癌复发主要危险因素及抗病毒治疗策略

窦晓光，丁    洋   

  1. 中国医科大学附属盛京医院感染科，辽宁沈阳110004 
  • 出版日期:2012-10-01 发布日期:2012-09-28

  • Online:2012-10-01 Published:2012-09-28

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摘要：

乙肝病毒（HBV）相关性原发性肝细胞癌（HCC）即使进行了根治性手术，肿瘤的复发率也很高。术后肿瘤的高复发是导致病人早期死亡的主要原因。术后肿瘤复发的危险因素包括病人原发肝病的严重程度、肝硬化分级、术前甲胎蛋白（AFP）水平、肿瘤的数目和大小、是否侵犯门静脉系统、是否有转移及手术切除的范围等。但对于HBV相关的HCC来说，术前HBV DNA载量及是否进行了有效的抗病毒治疗是标志病人术后存活期及无肿瘤复发生存的独立危险因素。早期、有效和规范的抗病毒治疗，既可预防肝功能衰竭，又可大大降低肿瘤术后的复发率，从而延长病人的存活期。

关键词: 乙肝病毒, 肝细胞癌, 肝切除, 复发

Abstract:

Main risk factors of hepatocellular carcinoma recurrence related to hepatitis B virus and anti-virus therapy strategies    DOU Xiao-guang，DING Yang. Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang110004, China
Corresponding author：DOU Xiao-guang，E-mail：douxg@sj-hospital.org
Abstract    The recurrence rate of hepatocellular carcinoma (HCC) related hepatitis B virus (HBV) remains high, which is the main cause of early death even after curative hepatectomy. The postoperative risk factors for early recurrence are related to the severity of disease，cirrhotic degree，vascular invasion，intrahepatic metastasis，AFP level > 1000 ng/mL，tumor number and size，curative hepatectomy  and so on. For HCC related to HBV，preoperative high viral load and effective anti-viral therapy are the independent risk factors for overall and recurrence-free survival. The early, effective and standard anti-viral therapy has potential beneficial effects for the prevention of liver function failure, reducing of postoperative recurrence of tumor and improving the survival of patients.

Key words: hepatitis B virus, hepatocellular carcinoma, hepatectomy, recurrence