与乙型肝炎或丙型肝炎相关的肝细胞癌患者相比，乙型和丙型肝炎相关的双癌肝细胞癌患者的手术结果。

Surgical results in patients with dual hepatitis B- and C-related hepatocellular carcinoma compared with hepatitis B- or C-related hepatocellular carcinoma.

作者信息

Chen M F, Jeng L B, Lee W C, Chen T C

机构信息

Department of Surgery, Chang Gung University, Chang Gung Memorial Hospital, Taipei, Taiwan.

出版信息

Surgery. 1998 May;123(5):554-9. doi: 10.1067/msy.1998.87237.

DOI:10.1067/msy.1998.87237

PMID:9591008

Abstract

BACKGROUND

The purpose of our study was to report on the surgical outcomes of patients with hepatocellular carcinoma (HCC) with dual hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and to assess the differences in the surgical results between those patients and the patients with hepatitis B- or hepatitis C-related HCC.

METHODS

The operative outcomes of 13 patients with hepatitis B surface antigen (HBsAg)-positive and hepatitis C antibody (HCV Ab)-positive (the BC-HCC group) results, 57 patients with HBsAg-positive and HCV Ab-negative (the B-HCC group) results, and 34 patients with HBsAg-negative and HCV Ab-positive (the C-HCC group) results, who had undergone hepatic resection from 1991 to 1995, were compared.

RESULTS

The operative mortality rate within 1 month after operation for patients with BC-HCC was 7.7%. No statistically significant difference was found compared with the patients with B-HCC and C-HCC (5.3% and 5.9%, respectively). The postoperative course of patients with BC-HCC was complicated by liver failure, postoperative ascites, and wound infection in one patient each. Also, no statistically significant difference was found among the groups (23.1%, 22.8%, and 20.5% for patients with BC-HCC, B-HCC, and C-HCC, respectively). The overall 1-, 3-, and 5-year survival rates of patients with BC-HCC in this series were 75%, 50%, and 40%, respectively. The postoperative recurrence rate was 66.7%. No statistically significant differences were found between the various groups of the virus-related HCC on the overall survival rate and disease-free survival rate.

CONCLUSIONS

Hepatic resection for HCC in patients with dual HBV and HCV infections was associated with slightly higher operative morbidity and mortality rates, but there were no statistical differences compared with hepatitis B- or C-related HCC regarding the survival and recurrence rates.

摘要

背景

我们研究的目的是报告乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）双重感染的肝细胞癌（HCC）患者的手术结果，并评估这些患者与乙型或丙型肝炎相关HCC患者手术结果的差异。

方法

比较了1991年至1995年期间接受肝切除术的13例乙型肝炎表面抗原（HBsAg）阳性和丙型肝炎抗体（HCV Ab）阳性患者（BC-HCC组）、57例HBsAg阳性和HCV Ab阴性患者（B-HCC组）以及34例HBsAg阴性和HCV Ab阳性患者（C-HCC组）的手术结果。

结果

BC-HCC患者术后1个月内的手术死亡率为7.7%。与B-HCC组和C-HCC组患者相比（分别为5.3%和5.9%），未发现统计学上的显著差异。BC-HCC患者的术后病程分别有1例出现肝衰竭、术后腹水和伤口感染。各组之间也未发现统计学上的显著差异（BC-HCC组、B-HCC组和C-HCC组患者分别为23.1%、22.8%和20.5%）。该系列中BC-HCC患者的1年、3年和5年总生存率分别为75%、50%和4-0%。术后复发率为66.7%。在总体生存率和无病生存率方面，不同病毒相关HCC组之间未发现统计学上的显著差异。