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目的探讨与乙型肝炎病毒(HBV)相关的原发性肝细胞癌(HCC)患者在肝移植术后肿瘤复发与乙型肝炎复发之间的相关关系。方法以52例与HBV相关的HCC患者为研究对象,回顾性分析这些患者的临床资料,根据肝移植后有无肿瘤复发,将患者分为肿瘤复发组(12例)和无肿瘤复发组(40例)。探讨两组间临床和病理特征的差异。结果在肿瘤复发组中,有10例患者的血清HBV表面抗体(抗-HBs)消失,其中4例在随访期间未发现HBV表面抗原(HBsAg)转阳,6例出现HBV表面抗原转阳。这6例患者首先表现为血清HBV免疫球蛋白(HBIg)药物浓度明显下降或消失,继而出现抗-HBs转阴,HBsAg转阳,2例患者的HBV-DNA复制呈阳性。而同期无肿瘤复发组的40例患者抗-HBs呈阳性,无HBsAg转阳。结论肝癌细胞染色体中存在整合的HBV- DNA,随着转移性肝癌细胞的增殖,HBV大量复制,最终出现乙型肝炎复发。
Objective To investigate the correlation between the relapse of tumor and the relapse of hepatitis B after liver transplantation in patients with primary hepatocellular carcinoma (HCC) associated with Hepatitis B virus (HBV). Methods Fifty-two patients with HBV-related HCC were enrolled in this study. The clinical data of these patients were retrospectively analyzed. According to the presence or absence of tumor recurrence after liver transplantation, the patients were divided into two groups: tumor recurrence group (12 cases) and tumor-free recurrence group example). To explore the differences between the two groups in clinical and pathological features. Results In the tumor recurrence group, the serum HBV surface antigens (anti-HBs) disappeared in 10 patients. No HBsAg positive was found in 4 cases during the follow-up period, and 6 cases showed HBV surface antigen turning positive. The six patients first showed the serum HBV immunoglobulin (HBIg) drug concentration decreased or disappeared, followed by anti-HBs negative, HBsAg positive, two patients with HBV-DNA replication was positive. In the same period, 40 patients without tumor recurrence were positive for anti-HBs, and no HBsAg was positive. Conclusion The integrated HBV-DNA exists in the chromosomes of hepatocellular carcinoma cells. With the proliferation of metastatic hepatocellular carcinoma cells, a large amount of HBV is replicated and finally the hepatitis B recurrence occurs.