Effect Of Antiviral Therapy On Perioperative And Second-stage Operation After Hepatocellular Carcinoma Intervention

Objective:Hepatocellular carcinoma is a common malignant tumor in China,surgical resection is the most effective way to treat liver cancer,but for advanced liver cancer,The best choice is the interventional treatment of liver cancer.In order to improve the perioperative safety and postoperative interventional resection rate.Therefore,this study:to explore the liver cancer intervention before and after the combined anti-virus in hepatitis B-related liver cancer intervention after perioperative safety and second-stage surgical resection probability.Methods:Retrospective analysis during from June 2012 to June2014 in Chenzhou City First People’s Hospital the Patient of hospitalization be diagnosis is advanced liver cance person,no surgical guidelines,previous history of non-hepatocellular carcinoma surgery,only the use of liver cancer interventional embolization(TACE)patients with 168 cases,and Follow up for 2 years.According to whether the combination of antiviral therapy before and after the combination of antiviral therapy into two groups(antiviral drugs using entecavir):before and after intervention the combined antiviral treatment for the antiviral group,106 cases,including 91 males and 15 females,the average age of54±10 years;Before and after intervention,62 cases were not treated with univariate antiviral therapy,including 54 males and 8 females with an average age of 51±12 years.The clinical data of the patients were collected,including age,sex,tumor size,transaminase,serum albumin,blood routine,alpha-fetoprotein,HBV-DNA,Child-Pugh classification,hepatitis B virus replication and other interventional and post-intervention complications.Year and 2-year survival rate,intervention after the second phase of surgical resection rate and so on.Statistical analysis was used to analyze the differences between the antiviral group and the control group data,Single factor and multiple factor regression analysis were used to analyze the correlation,and the significant level was 0.05.Results:There was no significant difference between the two groups in age and sex(P>0.05).During the perioperative period,the liver function(ALT,bilirubin and other indexes)in the antiviral group were significantly faster than those in the control group(P<0.05),The levels of alpha-fetoprotein and HBV-DNA in the antiviral group were significantly lower than those in the control group(P<0.05).The complication rate of the antiviral group was significantly lower than that of the control group(P<0.05),among which 43 cases(40.6%)were anti-virus group and 45cases(72.5%)in the control group,On the long-term efficacy,the antiviral group in the second phase of surgical resection rate was 25.5%(7/106),the control group was 14.5%(9/62),the former significantly higher than the latter(P<0.05);There was a significant difference between the antiviral group and the control group at 1 year survival rate(94.3%vs82.3%,P<0.05)and 2 year survival rate(89.6%vs 74.2%,P<0.05).Conclusion:Liver cancer before and after intervention,Hepatocar-cinoma combined with entecavir antiviral therapy can effectively inhibit the replication of HBV-DNA and reduce the amount of AFP,accelerate the recovery of liver function after intervention,and at the same time can prolong the survival of patients with liver cancer;for HBV-DNA copy>105copies/ml liver cancer patients,The combination of antiviral therapy before and after the intervention can reduce the incidence of complications after interventional therapy,and can effectively improve the perioperative safety.For patients with HCC after interventional therapy,the antiviral therapy can promote liver function recovery,AFP value decreased,thus increasing the number of patients with stage II surgery to improve liver resection rate;HBV-DNA copy>105copies/ml and No antiviral treatment before and after intervention was an independent predictor of perioperative safety;Portal vein tumor thrombus,extrahepatic metastasis,and no antiviral therapy before and after intervention were independent predictors of the two stage after interventional therapy,All HBV-related HCC patients with HBV-DNA levels>10~5copies/ml should receive antiviral therapy before and after hepatectomy.