HBV DNA载量对乙型肝炎相关肝癌手术治疗效果的影响

叶海雯; 邓勇; 张灵强; 王海久; 周瀛; 许晓磊; 樊海宁

doi:10.3969/j.issn.1001-5256.2018.09.035

HBV DNA载量对乙型肝炎相关肝癌手术治疗效果的影响

DOI: 10.3969/j.issn.1001-5256.2018.09.035

1. 青海大学研究生院
2. 青海大学附属医院肝胆胰外科

基金项目:

青海省临床重点建设专科(青财社字[2015]1714号)；

详细信息

中图分类号: R735.7
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- 被引次数: 0
出版历程
- 收稿日期: 2018-04-02
- 出版日期: 2018-09-20

Influence of HBV DNA load on surgical outcome of hepatitis B-associated liver cancer

Graduate School of Qinghai University

Research funding:

摘要

摘要: HBV感染在我国高度流行,长期HBV DNA高载量患者可进展为肝硬化进而导致肝癌的发生。目前,手术仍是治疗乙型肝炎相关肝癌的主要方法。大量研究表明,HBV DNA载量是影响乙型肝炎相关肝癌患者术后肝功能恢复、术后并发症的发生、肝癌复发及肝移植是否成功的重要因素。其机制可能与高HBV DNA载量和HBV再激活相关。通过抗病毒治疗使HBV DNA载量保持一定的低水平状态可改善乙型肝炎相关肝癌患者的预后。综述了术前、术后不同HBV DNA载量对乙型肝炎相关肝癌手术治疗效果的影响,旨在为研究治疗肝癌患者提供参考。
- 病毒载量 /
- 肝炎,乙型 /
- 肝肿瘤 /
- 外科手术 /
- 治疗结果
Abstract: HBV infection is highly prevalent in China, and patients with a high HBV-DNA load for a long time may progress to liver cirrhosis, which may lead to liver cancer. At present, surgery is still the main method for the treatment of hepatitis B-related liver cancer.Many studies have shown that HBV DNA load is an important influencing factor for the recovery of liver function after surgery, postoperative complications, recurrence of liver cancer, and the success of liver transplantation in patients with hepatitis B-related liver cancer. Its mechanism may be associated with high HBV DNA load and HBV reactivation. Maintaining a low HBV DNA load by antiviral therapy can improve the prognosis of patients with hepatitis B-related liver cancer. This article reviews the influence of HBV DNA load before and after surgery on the surgical outcome of hepatitis B-related liver cancer, in order to provide a reference for research on the treatment of patients with liver cancer.
- viral load /
- hepatitis B /
- liver neoplasms /
- surgical procedures, operative /
- treatment outcome

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参考文献(32)

[1]Chinese Society of Hepatology, Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B (2010 version) [J].J Clin Hepatol, 2011, 27 (1) :Ⅰ-ⅩⅥ. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南 (2010版) [J].临床肝胆病杂志, 2011, 27 (1) :Ⅰ-ⅩⅥ.

[2]TORRE LA, BRAY F, SIEGEL RL, et al.Global cancer statistics, 2012[J].CA Cancer J Clin, 2015, 65 (2) :87-108.

[3]CHEN W, ZHENG R, BAADE PD, et al.Cancer statistics in China, 2015[J].CA Cancer J Clin, 2016, 66 (2) :115-132.

[4]WANG FS, FAN JG, ZHANG Z, et al.The global burden of liver disease:the major impact of China[J].Hepatology, 2014, 60 (6) :2099-2108.

[5]LI X, CHEN Y, MA Z, et al.Effect of regulatory T cells and adherent cells on the expansion of HBc Ag-specific CD8+T cells in patients with chronic hepatitis B virus infection[J].Cell Immunol, 2010, 264 (1) :42-46.

[6]LI CD, CHEN XL, TIAN PF, et al.Correlation analysis of percentages of T lymphocyte subsets and CD4+CD25+regulatory T cells and HBV DNA level in peripheral blood of chronic hepatitis B patients[J].J Clin Hepatol, 2015, 31 (4) :541-545. (in Chinese) 李彩东, 陈锡莲, 田鹏飞, 等.慢性乙型肝炎患者外周血中T淋巴细胞亚群和CD4+CD25+调节性T淋巴细胞的表达水平与HBV-DNA定量的相关分析[J].临床肝胆病杂志, 2015, 31 (4) :541-545.

[7]YANG PL, ALTHAGE A, CHUNG J, et al.Immune effectors required for hepatitis B virus clearance[J].Proc Natl Acad Sci USA, 2010, 107 (2) :798-802.

[8]RAZA S, CLIFFORD GS.Worldwide variation in the relative importance of hepatitis B and hepatitis C viruses in hepatocellular carcinoma:a systematic review[J].British J Cancer, 2007, 96 (7) :1127-1134.

[9]WANG P, LI YC, YIN F.Relationship between preoperative HBV-DNA load and postoperative liver function recovery in patients with hepatitis B related hepatocellular carcinoma[J].J Hepatobiliary Surg, 2017, 25 (5) :370-373. (in Chinese) 王鹏, 李又春, 殷飞.乙肝相关性肝癌患者术前HBV-DNA载量水平与术后肝功能恢复的关系分析[J].肝胆外科杂志, 2017, 25 (5) :370-373.

[10]LIU H, WANG FM, LUO Y, et al.HBV promotes migration and invasion of hepatocellular carcinoma cell lines[J].Basic Clin Med, 2016, 36 (10) :1393-1399. (in Chinese) 刘辉, 王凤梅, 骆莹, 等.乙肝病毒促进肝癌细胞系的转移侵袭力[J].基础医学与临床, 2016, 36 (10) :1393-1399.

[11]SAITTA C, TRIPODI G, BARBERA A, et al.Hepatitis B virus (HBV) DNA integration in patients with occult HBV infection and hepatocellular carcinoma[J].Liver Int, 2015, 35 (10) :2311-2317.

[12]GONG WF, LU SD, ZHONG JH, et al.Influence of preoperative antiviral therapy on HBV reactivation and liver function after liver resection in HBV-DNA-negative hepatocellular carcinoma patients[J].Chin J Clin Oncol, 2016, 43 (15) :668-673. (in Chinese) 龚文锋, 陆世东, 钟鉴宏, 等.术前抗病毒治疗对HBV-DNA阴性肝细胞癌患者术后病毒再激活及肝功能的影响[J].中国肿瘤临床, 2016, 43 (15) :668-673.

[13] FU WZ, YANG L, HU XQ, et al.Relationship between HBV DNAload and HBV-M, ALT, AST content in the serum of chronic hepatitis B patients[J].Int J Virol, 2015, 22 (2) :111-114. (in Chinese) 付万智, 杨丽, 胡晓勤.慢性乙肝患者血清HBV-DNA载量与HBV-M、ALT、AST含量的关系研究[J].国际病毒学杂志, 2015, 22 (2) :111-114.

[14]VIZZINI GB, LUCA A, MARINO IR.Hepatitis B virus reactivation after a single session of transarterial chemoembolization in patients with hepatocellular carcinoma[J].Ann Int Med, 2003, 138 (8) :691-692.

[15]LEE JI, KIM JK, CHANG HY, et al.Impact of postoperative hepatitis B virus reactivation in hepatocellular carcinoma patients who formerly had naturally suppressed virus[J].J Gastroenterol Hepatol, 2014, 29 (5) :1019-1027.

[16]ZHONG S, YEO W, SCHRODER C, et al.High hepatitis B virus (HBV) DNA viral load is an important risk factor for HBV reactivation in breast cancer patients undergoing cytotoxic chemotherapy[J].J Viral Hepat, 2004, 11 (1) :55-59.

[17]HUANG G, LAU WY, SHEN F, et al.Preoperative hepatitis B virus DNA level is a risk factor for postoperative liver failure in patients who underwent partial hepatectomy for hepatitis B-related hepatocellular carcinoma[J].World J Surg, 2014, 38 (9) :2370-2376.

[18]YAO YT, AN ZM, LUO LY, et al.Relationship between preoperative hepatitis B virus DNA level and perioperative complications in patients with hepatitis B-related hepatocellular carcinoma[J].Chin J Gen Surg, 2016, 25 (1) :19-24. (in Chinese) 姚豫桐, 安志明, 罗兰云, 等.乙肝相关性肝癌术前乙型肝炎病毒DNA载量与围手术期并发症的关系[J].中国普通外科杂志, 2016, 25 (1) :19-24.

[19]XIE BX.Effect of antiviral therapy after radical surgery for hepatitis B-related liver cancer on patient prognosis[J].Chin J Cancer Prev Treat, 2016, 23 (s1) :164-165. (in Chinese) 谢碧霞.乙肝相关性肝癌根治性术后抗病毒治疗对于患者预后的影响[J].中华肿瘤防治杂志, 2016, 23 (s1) :164-165.

[20]AN HJ, JANG JW, SI HB, et al.Sustained low hepatitis B viral load predicts good outcome after curative resection in patients with hepatocellular carcinoma[J].J Gastroenterol Hepatol, 2010, 25 (12) :1876-1882.

[21]YAN PG, WANG RY, ZHANG J, et al.Impact of preoperative hepatitis B virus levels on prognosis after primary and repeat hepatectomies for hepatocellular carcinoma patients-a retrospective study[J].J Gastrointest Surg, 2018, 22 (5) :1-12.

[22]WANG P, ZHU ZY, LI CL, et al.Over expression of Eph A2 in different hepatocellular carcinoma cell lines and its relationship with HBV infection[J].Basic Clin Med, 2013, 33 (12) :1590-1594. (in Chinese) 王鹏, 朱争艳, 李成龙, 等.Eph A2在不同肝癌细胞系中过表达及其与乙肝病毒感染相关[J].基础医学与临床, 2013, 33 (12) :1590-1594.

[23]LIANG WY, REN SD, DUN ZN, et al.Clinical observation of a144-week entecavir therapy for HBe Ag-positive chronic HBVcarriers with high viral load[J].Int J Virol, 2017, 24 (3) :187-191. (in Chinese) 梁文艳, 任树冬, 敦志娜, 等.恩替卡韦治疗高病毒载量HBe Ag阳性慢性HBV携带者144周的临床观察[J].国际病毒学杂志, 2017, 24 (3) :187-191.

[24]DING C, PAN F, HU HZ, et al.Efficacy of antiviral therapy in hepatocellular carcinoma patients with high HBV DNA levels after radical resection[J].J Clin Hepatol, 2014, 30 (7) :656-659. (in Chinese) 丁晨, 潘凡, 胡还章, 等.HBV-DNA高载量的肝细胞癌患者肝癌根治术后抗病毒治疗疗效观察[J].临床肝胆病杂志, 2014, 30 (7) :656-659.

[25]GUO XP, LIU YW, WANG W, et al.Treatment of liver cirrhosis with postoperative hepatocellular carcinoma with nucleoside analog[J].J Clin Hepatol, 2010, 26 (4) :425-427. (in Chinese) 郭西萍, 刘彦威, 王婉, 等.核苷类抗病毒治疗伴活动性肝硬化肝癌术后的临床观察[J].临床肝胆病杂志, 2010, 26 (4) :425-427.

[26]CHEN CJ, YANG HI, ILOEJE UH, et al.Hepatitis B virus DNAlevels and outcomes in chronic hepatitis B[J].Hepatology, 2009, 49 (5 Suppl) :72-84.

[27]HUANG G, LI PP, LAU WY, et al.Antiviral therapy reduces hepatocellular carcinoma recurrence in patients with low HBV-DNA levels:a randomized controlled trial[J].Ann Surg, 2018.[Epub ahead of print]

[28]SAMUEL D, FERAY C, BISMUTH H.Hepatitis viruses and liver transplantation[J].J Gastroenterol Hepatol, 1997, 12 (9-10) :s335.

[29]MCCAUGHAN GW.Prevention of post liver transplant HBV recurrence[J].Hepatol Int, 2011, 5 (4) :876-881.

[30]WANG FS, SHEN ZY, YUAN GY, et al.The influence factors for hepatitis B virus re-infection after liver transplantation[J].Chin JPrac Intern Med, 2009, 29 (12) :1112-1114. (in Chinese) 王凤水, 沈中阳, 袁桂玉, 等.肝移植术后乙型肝炎病毒再感染的影响因素研究[J].中国实用内科杂志, 2009, 29 (12) :1112-1114.

[31]ZHENG JF, HAN DK, LI L, et al.Intramuscular hepatitis B immunoglobulin combined with entecavir for long-term prophylaxis of hepatitis B re-infection after liver transplantation[J].World Chin J Dig, 2009, 17 (7) :716-719. (in Chinese) 郑俊福, 韩大康, 李丽, 等.恩替卡韦联合乙肝免疫球蛋白预防肝移植术后乙肝再感染[J].世界华人消化杂志, 2009, 17 (7) :716-719.

[32]LEE S, KWON CH, MOON HH, et al.Antiviral treatment for hepatitis B virus recurrence following liver transplantation[J].Clin Transplant, 2013, 27 (5) :e597-e604.

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