Analysis Of Effect And Related Factors Affecting Liver Function For Hepatocellular Carcinoma After TACE

ObjectivePrimary liver cancer is one of the common malignant tumors in our country, it has high malignant degree and high fatality rate. Recent years Means of treatment of liver cancer are in the unceasing development,.The appearance of the interventional treatment prolonged the survival of patients with primary liver cancer. This study retrospectively analyzed of120patients of primary liver cancer who were treated with conventional TACE.To study patients’liver function after treatment with TACE, at the same time state its influence factors including TACE times, portal vein tumor emboli,HBeAg, classification of Child-Pugh and HBV-DNA.MethodsFrom September2012to June2013,there were120patients had received the treatment with TACEin northern jiangsu people’s hospital who were diagonised as middle-late stage primary liver cancer (hepatocelluar carcinoma, HCC), among them98cases were male,22cases were female, the sex ratio was4.45:1, Their age from33to79, their median age was52. Before treatment there were89cases without portal vein tumor embolio and31cases with portal vein tumor emboli; There were48cases received therapy of TACE one time,45cases were twice,27cases were more than three times;95patients were HBsAg positive, HBeAg positive for36cases, HBeAg negative were59cases;86patients were Child-Pugh grade A,34patients were Child-Pugh class B; low HBV-DNA degree were58cases, middle and high HBV-DNA were38cases.Liver function is detected by automatic biochemical analyzer Dxc800TB machine, HBV markers in serum is detected by chemiluminescence method, HBV-DNA is used real-time polymerase chain reaction assay. We used SPSS13.0software package for statistical analysis, measurement data used t test, comparison between count data set by chi-square test, P <0.05for the difference was statistically significant.Results1. There is damagination on liver function after the treatment of TACE.Patients with primary hepatocellular carcinoma elevated liver function:ALT, AST, TBIL, DBIL3days、a week after TACE operation were higher than the preoperative, were statistically significant (P<0.05). The liver function after a month:compared with that before operation, ALT, AST, TBIL, DBIL was increased, serum albumin (ALB) was decreased, prothrombin time (PT) was prolonged, but no significant difference (P>0.05); Liver injury can occur after TACE treatment, but liver function damage is reversible.2. Effects of TACE therapy times in patients with hepatocellular carcinoma on liver function:TACE1time accounted for40%(48cases), TACE2times accounted for37.5%(45cases), TACE>3times accounted for22.5%(27cases), between the three groups after χ2test, with statistical significance (P<0.05).3.Effects of portal vein tumor thrombus on liver function after TACE:with portal vein tumor thrombus accounted for51.67%(31cases), no portal cancerous thrombus accounted for48.33%(89cases), two groups by x2test, with statistical significance (P<0.05).4.Patients with positive HBeAg positive liver injury rate:the positive rate of HBsAg was79.17%(95cases); the positive rate of HBeAg was37.89%(36cases), HBeAg negative rate was62.11%(59cases), between the two groups after χ2test, with statistical significance (P<0.05).5.Low titer of HBV-DNA in58cases,38cases were middle-high and high, between two groups after χ2test, with statistical significance (P<0.05).6.There is no significant differences in the changes of liver function Child-Pugh grade A and grade B were treated with TACE, Child grade B patients with high HBV-DNA titers in patients with hepatocellular carcinoma after TACE proportion of liver function damage was higher and liver injury was more serious.Child-Pugh A patients accounted for71.67%(86cases), Child-Pugh grade B patients accounted for28.33%(34cases) after TACE, the change of liver function between the two groups after χ2test, was no statistical significance (P<0.05). Child-Pugh A in patients with low titer was40cases,23cases of middle high titer, between the three groups after χ2test, was no statistical significance (P>0.05). Child-Pugh B level in patients with a total of34cases,15cases of Child-PughB low titer of HBV-DNA,18cases with middle high, between two groups after χ2test, with statistical significance (P<0.05).Conclusion1.TACE can cause transient liver function injury, but conventional liver protecting medicine can improve liver function,.It suggests that TACE patients should be routine liver protective therapy.2.Portal vein tumor thrombus, times of TACE, preoperative HBV-DNA titer are liver function injury related factors; It suggests that this kind of patients with the treatment of TACE, we should assess of liver function and virus titer situation.3.Patients with positive HBeAg had liver function injury incidence increased; Child-Pugh classification of A and B showed no difference, but the Child B level in patients with high HBV-DNA titers in patients with hepatocellular carcinoma in after interventional therapy, liver dysfunction significantly higher proportion, injury.