The Inhibitory Synergistic Effect Of The Resection Of Liver Cancer Combined With HBsAg(+) And The Using Of Entecavir To HBV

Objective: The purpose of this article is to evaluate the inhibition effect to thereplication of HBV producted by Entecavir and hepatectomy in the patients withHCC combined with positive-HBsAg.Methods: we statistical analyze the95cases,undergo hepatectomy, of HCCcombined positive-HBsAg and the27cases of positive-HBsAg from September2012to June2014in First Hospital of Jilin University. All of the patientswere not undergo antiviral therapy.The patients who were received hepatectomywere randomly divided into two groups, one group received anriviral therapy withentecavir,the other group were given placebo..The antiviral-group3daysbefore operation by a way of entecavir1.0mg/d, and maintain the dose.inlong-term.Simple antiviral group received entecavir for4weeks.Comparethe clinical data of the two group including gender, age, general healthstatus,HBV-DNA on preoperative day1and postoperative4weeks,WBC, liverfunction, tumor recurrence rate within1years of and so on.Compare the replicationof HBV between the antiviral group combined with hepatecomy and the simpleantiviral group.Results: Ultimately, there were20men and29women who complete the testin hepatectomy group. There were10men and15women completed the test insimple antiviral-group In the patients received antiviral therapy, thealbumin35.0g/l （32.4g/l~37.1g/l） vs33.9g/l （32.7g/l~35.9g/l) andcholinesterase(3622.67IU/ml±1086.77IU/ml)vs(3205.17IU/ml±1204.02)IU/ml inlow replication group was higher than the highr replication group. Only1patientin antiviral group (4.2%) was happened the reactivation of HBV. However,therewere10patients (40%)were happened the reactivation of HBV in antiviral group.Inaddition, the reactivation of HBV would increased the recurrence rate of the tumor（p=0.011，OR(95%CI,(1.532~28.120)）.The decreasing number of HBV wasabout1000copies in enticavir-group combined with hepatectomy compared with100copeies in simple enticavir-group Conclusion: This article demonstrate that the antiviral therapy using enticavirand the the radical operation of HCC combined with positive-HBsAg has asynergistic effect to inhibit the replication of HBV.To futher confirmed that theusing of enticavir in the patients has a HCC combined with positive-HBsAgudergone hepatectomy has a excellent effect and helpful to reduce the rate ofcomplication and tumor recurrence.And it’s safe to take the antiviral treatment usingenticavir during preoprative period. Enticavir is suitable for the antiviral treatmentin patients of HCC combined with positive-HBsAg in preoprative period.