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目的探讨单纯及合并乙型肝炎病毒(HBV)与丙型肝炎病毒(HCV)感染对肝细胞性肝癌患者手术后癌症复发转移的影响,以及HBV、HCV感染对患者术后复发转移的可能因素,以指导临床采取适当时机进行治疗。方法选取2010年3月-2013年10月安徽医科大学第一附属医院肝胆外科施行肝癌根治性切除手术的肝细胞性肝癌患者作为研究对象,从术后6个月的患者中随机选取90例,对其进行HBV和HCV感染检测,根据检测结果将患者分为A、B、C、D组,A组为HBV(-)、HCV(-);B组为HBV(+)、HCV(-);C组为HBV(-)、HCV(+);D组为HBV(+)、HCV(+),对比单纯及合并HBV、HCV病毒感染对患者肝癌复发转移率的影响,并回顾性分析患者临床病理资料,探讨病毒感染对患者术后复发转移的影响因素。结果 ELISA法检测到HCV感染阳性9例,阳性率为10.0%,nRT-PCR法检测HCV阳性25例,阳性率为27.8%,两种检测方法差异有统计学意义(P<0.05);D组患者术后复发率较A、B、C组高,差异有统计学意义(P<0.05);B、C组患者的术后复发率显著高于A组患者(P<0.05),B、C两组患者间肝癌复发率差异无统计学意义;患者年龄、肿瘤大小、肝硬化程度以及肿瘤分化程度在A、B、C、D组间,差异有统计学意义(P<0.05)。结论 nRT-PCR法检测HCV感染的特异性更高,HBV和HCV感染对肝细胞性肝癌患者术后更易复发转移。
Objective To investigate the effect of simple and combined hepatitis B virus (HBV) and hepatitis C virus (HCV) infection on the recurrence and metastasis of hepatocellular carcinoma after operation and the possible factors of postoperative recurrence and metastasis of HBV and HCV infection, To guide the clinical take the appropriate time for treatment. Methods From March 2010 to October 2013, patients with hepatocellular carcinoma who underwent radical resection of hepatocellular carcinoma undergoing hepatobiliary surgery in the First Affiliated Hospital of Anhui Medical University from September to October 2013 were selected as the research objects. Ninety patients were randomly selected from patients 6 months after operation, The patients were divided into groups A, B, C and D according to the test results. The patients in group A were HBV (-) and HCV (-), HBV (+) and HCV , HCV (+) and HCV (+) in group C, HBV (+) and HCV (+) in group C, and the effect of HBV and HCV infection on the recurrence and metastasis of hepatocellular carcinoma in patients of group C and retrospectively analyzed Clinical and pathological data to explore the impact of viral infection on postoperative recurrence and metastasis of patients. Results Nine positive cases of HCV infection were detected by ELISA. The positive rate was 10.0%. In the nRT-PCR assay, 25 cases were positive for HCV, the positive rate was 27.8%. The difference between the two methods was statistically significant (P <0.05) The postoperative recurrence rate of patients was significantly higher than that of A, B and C groups (P <0.05). The recurrence rates of patients in group B and C were significantly higher than those in group A (P <0.05) There was no significant difference in the recurrence rate of HCC between the two groups. The age, tumor size, degree of cirrhosis and tumor differentiation were statistically significant (P <0.05) between A, B, C and D groups. Conclusion The detection of HCV infection by nRT-PCR is more specific, and HBV and HCV infection are more likely to recur in patients with hepatocellular carcinoma.