Wu C C, Tang J S, Lin M C, Yeh D C, Liu T J, P'eng F K
Department of Surgery, Taichung Veterans General Hospital, Chung-Shan Medical College, Taiwan.
Hepatogastroenterology. 1999 Mar-Apr;46(26):651-5.
BACKGROUND/AIMS: The differences of liver resection for hepatocellular carcinoma (HCC) between hepatitis B and C-related cirrhotic liver remain unknown. This study compares the surgical results of HCC in hepatitis B and hepatitis C-related cirrhotic patients in an area endemic of hepatitis B.
A retrospective comparison of the clinicopathological features and early and long-term results of 110 cirrhotic patients with seropositive hepatitis B surface antigen only (group B) and 55 patients with seropositive anti-hepatitis C antibody only (group C) was carried out.
Group C patients were older, had a lower serum alpha-fetoprotein level, greater indocyanine retention rate, and higher incidence of multicentric tumors. Tumor size was larger and there was a higher incidence of combined satellite nodules in group B patients. There were no significant differences in operative morbidity and mortality between the two groups. Group B patients had a slightly shorter disease-free interval (p = 0.07) but a better actuarial survival rate (p = 0.05) than group C patients.
The hepatitis status did not affect the operative risks in cirrhotic livers. However, after resection of HCC, poorer liver functional reserve in hepatitis C-related cirrhotic patients caused poorer actuarial survival rate when compared with hepatitis B-related cirrhotic patients.
背景/目的：乙型肝炎和丙型肝炎相关肝硬化肝脏的肝细胞癌（HCC）肝切除术的差异尚不清楚。本研究比较了乙肝高发地区乙型肝炎和丙型肝炎相关肝硬化患者 HCC 的手术结果。
对 110 例仅乙肝表面抗原血清学阳性的肝硬化患者（B 组）和 55 例仅丙肝抗体血清学阳性的患者（C 组）的临床病理特征、早期和长期结果进行回顾性比较。
C 组患者年龄较大，血清甲胎蛋白水平较低，吲哚菁绿潴留率较高，多中心肿瘤发生率较高。B 组患者肿瘤体积较大，合并卫星结节的发生率较高。两组患者的手术发病率和死亡率无显著差异。B 组患者的无病生存期略短（p = 0.07），但精算生存率优于 C 组患者（p = 0.05）。
肝炎状态不影响肝硬化肝脏的手术风险。然而，与乙型肝炎相关肝硬化患者相比，丙型肝炎相关肝硬化患者在切除 HCC 后，肝功能储备较差导致精算生存率较低。
