Clinical Analysis Of The Hepatic Injury And The Prophylactic Antivirus Treatment In Lung Cancer Patients With Hepatitis B Virus Infection

BackgroundPrimary bronchogenic carcinoma(lung cancer)is the most frequent malignant neoplasm in most countries,and the main cancer-related cause of mortality all over the world every year.Latest data show that the incidence and mortality of lung cancer in all malignant tumors is number 1,which is still on the rise year by year in the female,the average annual growth of 0.9%.Hepatitis B virus(HBV)infection is an important public health problem in worldwide.The HBsAg positive prevalence of 3.61% on the world.The global statistical data found that about 2 billion people had been infected with HBV,of which240 million people with chronic HBV infection.As one of the most severe countries of hepatitis B virus infection,Chinese latest data show that HBsAg positive prevalence is7.18% in the general population.Lung cancer patients with HBV infection is common.According to report the positive rate of HBsAg in cancer patients was 12%.Some scholars believe that the HBV infection is an independent risk factor for poor prognosis in lung cancer patients.When lung cancer patients with HBV infection receiving chemotherapy,targeted,immune and other related treatment,there are liver dysfunction,HBV reactivation(HBVR)risk.Previous studies have found a significant risk of liver dysfunction and HBVR during the the patients received treatment of blood system tumors.During the treatment of solid tumor patients with HBV infection,the risk of liver function injury is less studied.ObjectiveThis study aimed to determine the correlation of liver function damage in lung cancer patients with or without hepatitis B virus infection,and the differences of the hepatitis B virus reactivation(HBVR)with or without prophylactic antivirus treatment.MethodsCollect 61 cases of lung cancer patients with HBsAg positive and 61 cases of lung cancer patients with HBsAg-negative in the Changhai Hospital from 2015.06 to2017.06.Compared the liver function of HBsAg-negative group and HBsAg-positive group patients.Divided the HBsAg positive group into the intervention group(prophylactic antiviral group)and the control group(without prophylactic antiviral).The intervention group oral antiviral drugs entecavir 0.5mg,lamivudine 100 mg once daily for 1weekbefore antitumor treatment.Observe the level of serum liver function on the 1st,3rd,and5 th hospitalization in each group.Counted the incidence of HBV reactivation in the intervention group and the control group.ResultsAt the third cycle,the AST(P=0.048)、TBil(P=0.012)、PA(P=0.01)were statistical difference between the HBsAg-positive group and the HBsAg-negative group.The ALT level of the intervention group was different from the HBsAg-negative group at the first cycle(P=0.029).At the 3rd and 5rd cycles,there was no significant difference on the level of ALT.The number of abnormal ALT,AST and PT on the intervention group were significantly lower than the control group(P<0.005).The ALT value(P=0.003),AST value(P=0.007)and TBil value(P=0.024)of the intervention group was lower than the control group at the 3rd cycle.Intervention group compared with the control group the incidence of liver function impairment was 3.40% vs 25%.The rate of moderate and severe liver injury patients were 0% and87.5% in intervention group and control group.HBV-DNA reactivation rate was 9% in intervention group.In control group HBV-DNA reactivation rate was 19%.ConclusionHBsAg-positive lung cancer patients are more likely to have liver function impairment than HBsAg-negative patients.Prophylactic antivirus treatment can significantly reduce the occurrence of HBV reactivation.