Evaluate Therapeutic Effects Of ASntiviral Treatment For Hepatitis B Virus-related Primary Liver Cancer

AIM:To evaluate therapeutic effects of antiviral treatment hepatitis B virus-primary liver cancer (PLC).METHODS:We collected patients of primary liver cancer caused by hepatitis B from January 2005 to December 2009, in China and Japan Union Hospital digestive department and intervention department of Jilin University. They conformed to《Diagnosis Standards and Criyerion of the Primary liver Cancer》[9],which was established in 2001,and choose patients with a total of 95 patients,80men,15 women,proportion is 5.33:1.he average age of patients is 53.10±10.14. According to patients' ondition and individual will, we divided the treatment into 4 different groups:antiviral combined with interventional therapy group(n=22),intervention group(n=26),antiviral treatment group(n=23),supportive treatment group(n=24). All the interventional therapy adopt transarterial chemoembolization(TACE) (the mean time of antiviral combined with interventional therapy group is 4.6±1.5;he mean time of antiviral treatment group is 5±2.1); the antiviral adopt nucleside analogues(Lamivudine,Entecavir,elbivudine),the course of treatment is from diagnosis PLC to death(the course of antiviral combined with interventional therapy group is 44±9.62 weeks, the course of ntiviral treatment group is 43.71±9.47 weeks). Compare Liver function HBV DNA,hepatitis B surface markers,othrombin time,tumor markers between antiviral combined with interventional therapy group,intervention group,antiviral treatment group and supportive treatment group.Follow-up the patients' uality of life,including appetite,weight(rule out ascites) by phone or on site every 4 weeks.All patients follow-up 4 weeks to 48weeks.RESULTS:The ALT levels of antiviral combined with interventional therapy group,intervention group and antiviral treatment group is much better with longer treatment. ALT levels of antiviral combined with interventional therapy group is lower than intervention group and antiviral treatment group at the twenty forth week and the forty eighth week after treatment,has statistically significant difference (P<0.05).ALT levels of intervention group and antiviral treatment group is also lower than supportive treatment group significantly (P<0.05). HBV DNA levels of antiviral combined with interventional therapy group and antiviral treatment group reduce with longer treatmentat,the HBV DNA suppression rate is 27.3%,26.1% at the forth week,36.4,34.7% at the twelfth week,45.5%,47.8% at the twenty forth week and 72.7%,47.8% at the forty eighth week respectively after treatment,higher than interventional therapy group and supportive treatment group significantly (P<0.05).There is no change with interventional therapy group and supportive treatment group.It do not have difference of HBV DNA between differet antiviral drugs. At the forty eighth week HBeAg negative rate of antiviral combined with interventional therapy group and antiviral treatment group is 42.9%,36.4%, HBeAg seroconversion rate is 14.3%,18.2% respectively.There is no HBeAg undetectable or conversion with interventional therapy group and supportive treatment group.The HBeAg negative rate and HBeAg seroconversion rate of antiviral combined with interventional therapy group and antiviral treatment group is higher than interventional therapy group and supportive treatment group significantly (P<0.05).AFP, CA199 levels of antiviral combined with interventional therapy group,intervention group and antiviral treatment group decrease with longer treatmentat.At the twenty forth week,AFP levels of antiviral combined with interventional therapy group decrease significantly (P<0.05),is much lower than interventional therapy group,antiviral treatment group and supportive treatment group(P<0.05). AFP levels of interventional therapy group and antiviral treatment group is lower than supportive treatment group(P<0.05).At at the forty eighth week CA199 levels of antiviral combined with interventional therapy group decrease significantly (P<005), is much lower than interventional therapy group,antiviral treatment group and supportive treatment group(P<0.05).CA199 levels of interventional therapy group and antiviral treatment group is lower than supportive treatment group(P<0.05). Child-Pugh score of different treatments increase with longer treatment, Child-Pugh score of antiviral combined with interventional therapy group,interventional therapy group and antiviral treatment group is lower than supportive treatment group(P<0.05) at at the twenty forth week and the forty eighth week.The Child-Pugh score of antiviral combined with interventional therapy group is also lower than interventional therapy group and antiviral treatment group(P<0.05).The survival rate of antiviral combined with interventional therapy group,interventional therapy group,antiviral treatment group and supportive treatment group is 86.4%,73.1%,73.9%,54.2% t the twenty forth week,68.2%,46.2%,47.8%,16.7% t the forty eighth week respectively. The 1 year survival rate of antiviral combined with interventional therapy group,interventional therapy group,antiviral treatment group is higher than supportive treatment group(P<0.05).The quality of life of antiviral combined with interventional therapy group,interventional therapy group,antiviral treatment group is much better after treatment,and antiviral combined with interventional therapy group is the best,there is no change with the patients of supportive treatment group.CONCLUSION:Basis on interventional therapy and supportive therapy,using antivival can improve the ALT levels of hepatitis B virus-primary liver cancer patients. HBV DNA levels of antiviral combined with interventional therapy group and antiviral treatment group is lower than interventional therapy group and supportive treatment group at the forth week,the twelfth weeks the twenty forth week and the forty eighth week;the HBV DNA suppression,HBeAg seroconversion rate and HBeAg negative rate is higher than interventional therapy group and supportive treatment group.The AFP levels and Child-Pugh score of antiviral combined with interventional therapy group and antiviral treatment group is lower than interventional therapy group and supportive treatment group at the twenty forth week and the forty eighth week,and AFP decrease significantly at the twenty forth week and the forty eighth week.The CA199 levels is lower than interventional therapy group and supportive treatment group at the forty eighth week. Basis on interventional therapy and supportive therapy,using antivival can improve quality of life and 1 year survival rate of hepatitis B virus-primary liver cancer patients.