HBV感染抗病毒治疗中发生肝细胞癌24例临床分析-论文.pdf

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1、8·论著·中国肝脏病杂志(电子版)》2014年第6卷第1期HBV感染抗病毒治疗中发生肝细胞癌24例临床分析赵世印1,2雷旭。，李芳，李金科，谭华炳(1．湖北医药学院附属人民医院感染性疾病科、肝病研究室，湖北十堰442000；2．湖北省房县红塔镇卫生院，湖北房县442100；3．湖北中医药大学临床学院，武汉430035)摘要：目的探讨HBV感染抗病毒治疗过程中发生肝细胞癌(HCC)的原因和诊断方法。方法回顾性分析24例HBV感染(肝炎后肝硬化者l8例、CHB者6例)抗病毒治疗过程中发生HCC的病例，分

2、析其发生原因及诊断方法。结果HBV感染抗病毒过程中发生HCC常见。患肝病时间、男性、抗病毒治疗效果不佳(或发生病原学突破)、吸烟、饮酒、糖尿病是抗病毒治疗过程中发生HCC常见原因。肝硬化发展至肝癌常无症状，慢性肝炎发展至肝癌常有肝区不适、生物化学检测结果异常、HBV载量变化。AFP、彩色多普勒超声、CT联合检查基本可以完成HCC的临床诊断，必要时辅以肝脏病理学检查。结论HBV感染抗病毒过程中发生HCC常见，提高认识有利于早期发现HCC。关键词：肝炎病毒，乙型；抗病毒治疗；肝肿瘤；诊断Clinical

3、analysisof24casesofhepatocellularcarcinomahappenedthathepatitisBvirusinfectionwastreatedintheprocessofantiviralZHAOShi-yin，LEIXu，LIFang，LIJin-ke，TANHua—bing．DepartmentofInfectiousDisease，DepartmentofLiverD~ease,RenminHospital,HubeiUniversityofMedicine，

4、ShiyanCity442000,China；2．F口ngCountyHongtaTownshipHealthCenter,FnngCounty442100,China；3．ClinicalCollegeofHubeiUniversityofTraditionalChineseMedicine，Wuhan430035，Chin口)Abstract：ObjectiveToinvestigatcausesanddiagnosismethodofhepatocellularcarcinomathathep

5、atitisBvirusinfectionwastreatedintheprocessofantivira1．MethodsThecausesanddiagnosismethodwasretrospectiveanalysedof24casesofhepatocellularcarcinoma(18casesofposthepatiticlivercirrhosis，6casesofchronichepatitisB、thathepatitisBvirusinfectionwastreatedint

6、heprocessofantivira1．ResultsThehepatocellularcarcinomawasmoreCOlTlmonthathepatitisBvirusinfectionwastreatedintheprocessofantivira1．ThethemostcommoncauseofhepatocellularcarcinomahappenedthathepatitisBvirusinfectionwastreatedintheprocessofantiviralisthet

7、imeofliverdisease，male，poorefectofantiviraltreatment(orpathogenicbreakthrough)，diabetes．Itisoftenasymptomaticfromlivercirrhosistohepatocellularcarcinoma．Theprogressionofchronichepatitistohepatocellularcarcinomaoftenhasliverareaunwell，biochemicalchanges

8、，changesintheamountofthehepatitisBvirus．Clinicaldiagnosisofhepatocellularcarcinomawascompletedwithalpha—fetoprotein(AFP)，colordopplerultrasound，CLandtheliverpathologywasimplemented．ConclusionsThehepatocellularcarcinomawasmorecomonthathe