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时间:2020-05-07
《乙、丙型肝炎病毒感染与原发性肝癌预后相关性研究-论文.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、·326·中国医师杂志2014年3月第16卷第3期JournalofChinesePhysician,March2014.Vo1.16。No.3·论著·乙、丙型肝炎病毒感染与原发性肝癌预后相关性研究付广双张晶芬程海涛刘金玲张晓玲袁静王立红王彦宽王政慧李春荣刘丽杜金华中恩华李欣杉王茉莉【摘要】目的探讨乙、丙型肝炎病毒感染与原发性肝癌预后相关的新因素。方法回顾性分析已确诊的130例原发性肝癌病例,应用Cox回归模型针对有意义的因素及既往曾报道的与原发性肝癌预后有关的可能因素进行多因素分析,筛选出有独立显著意义的预后因素。结果HBV
2、DNA、HCVRNA水平、病毒感染持续时间与中位生存期呈直线负相关,与肿瘤复发或转移率成直线正相关;不同治疗模式的预后差异有统计学意义(P<0.05);乙、丙型肝炎病毒载量、病毒感染持续时间、治疗模式、治疗前血清甲胎蛋白(AFP)水平、child-Pugh分级以及是否存在肝外远处转移、门脉癌栓对原发性肝癌患者预后影响显著(P<0.05);与HBV相关原发性肝癌患者相比,HCV相关原发性肝癌患者中位生存期较长,1—3年内的累积生存率较高,具有较好的预后,差异均有统计学意义(P<0.05)。结论HBVDNA、HCVRNA水平、病毒
3、感染持续时间是与原发性肝癌预后相关的新因素。【关键词]肝炎,乙型;肝炎,丙型;肝肿瘤;预后;病毒载量AnalysisofrelationshipbetweenhepatitisnorCvirusinfectionandhepatocellularcarcinomaprognosisFuGuangshuang,ZhangJingfen,ChengHaitao,LiuJinl~ng,ZhangXiaoling,YuanJing,WangLihong,WangYankuan,WangZhenghui,LiChunrong,LiuLi
4、,DuJinhua,ShenEnhua,LiXinshan,WangMoli.DepartmentofInfectiousDiseases,GeneralHospitalofFAW,Changchun130011,China【Abstract】ObjectiveToinvestigatetherelationshipbetweenhepatitisBorCvirusinfectionandhepatocellularcarcinomaprognosis.MethodsAfollow-upretrospectiveanalysi
5、sof130patientswhohad,beendiagnosedasprimaryhepatocarcinoma(PHC)inourhospitalwasperformed.ThepossiblefactorsandthefactorsthathadbeenreportedpreviouslymeaningfultoPHCwereanalyzedwithCoxregression(multivariateanalysis).Independentsignificantprognosticfactorsweretobescr
6、eenedout.ResultsHBVDNA,HCVRNAlevel,anddurationofviralinfectionwerenegativelycorrelatedwiththemediansurvival,respectively.However,theyhadapositivelinearcorelationwithrateoftumorrecurrenceormetastasis,respectively.Therewasasignificantdifferenceinprognosisa—mongdiferen
7、ttreatmentmodalities(P<0.05);TheviralloadofhepatitisBandC,virusinfectionduration,treatmentmodalities,pretreatmentserumAFPlevel,bilirubinlevelsandthepresenceofascites,extrahepaticmetastasisandportalveinthrombosishadsig—nificantimpactontheprognosisofpatientswithPHC(P<
8、0.05).ComparedwithHBV—relatedPHCpatients,HCV—relatedPHCpa-tientshadthelongermediansurvivalperiod,thecumulativesurvivalrateat3yearswashighe
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