Kubo S, Hirohashi K, Tanaka H, Tsukamoto T, Shuto T, Higaki I, Takemura S, Yamamoto T, Nishiguchi S, Kinoshita H
Second Department of Surgery, Osaka City University Medical School, Osaka, Japan.
Dig Surg. 2001;18(1):26-33. doi: 10.1159/000050093.
BACKGROUND/AIMS: During the natural course of hepatitis B virus (HBV) infection, clearance of HB e antigen (HBeAg) and HB surface antigen (HBsAg) occurs with remission of liver disease. We investigated the effects of postoperative changes in virologic and biochemical parameters on the prognosis after liver resection for HBV-related hepatocellular carcinoma (HCC).
We investigated the relationship between postoperative changes in virologic and biochemical parameters and the incidence of intrahepatic recurrence and the outcome during a 3-year period following surgery in 30 HCC patients with HBsAg.
The incidence of intrahepatic recurrence of HCC was significantly higher in patients with acute postoperative exacerbation of hepatitis (p = 0.0084), a sustained high serum concentration of HBV DNA (> or = 5.0 mEq/ml, p = 0.001), and sustained expression of HBsAg after surgery (p = 0.0421). A high serum concentration of HBV DNA was significantly associated with a shorter survival time (p = 0.0447) and the cause of death was recurrence of HCC.
Patients with acute postoperative exacerbation of hepatitis, sustained HBsAg expression, and sustained high serum concentrations of HBV DNA after surgery may require more intensive postoperative monitoring for HCC recurrence.
背景/目的：在乙型肝炎病毒（HBV）感染的自然病程中，随着肝病的缓解，HBe抗原（HBeAg）和HB表面抗原（HBsAg）会清除。我们研究了病毒学和生化参数的术后变化对HBV相关肝细胞癌（HCC）肝切除术后预后的影响。
我们研究了30例HBsAg阳性的HCC患者术后病毒学和生化参数变化与肝内复发发生率及术后3年结局之间的关系。
术后肝炎急性加重的患者（p = 0.0084）、术后血清HBV DNA持续高浓度（≥5.0 mEq/ml，p = 0.001）以及术后持续表达HBsAg的患者（p = 0.0421），HCC肝内复发的发生率显著更高。血清HBV DNA高浓度与较短的生存时间显著相关（p = 0.0447），死亡原因是HCC复发。
术后肝炎急性加重、术后持续HBsAg表达以及术后血清HBV DNA持续高浓度的患者可能需要更密切的术后监测以观察HCC复发情况。
