病毒性肝病抗病毒治疗期间新发肝癌7例临床分析

目的:探讨病毒性肝炎肝硬化患者经抗病毒治疗仍发生原发性肝癌的原因。方法:回顾性分析兰州大学第一医院东岗院区肝病中心在2012年10月-2013年6月收治的7例病毒性肝炎肝硬化患者在规范抗病毒治疗期间新发原发性肝癌的临床资料、抗病毒治疗情况。结果:7例患者中有HBV感染6例,HCV感染1例;慢性肝炎2例,肝硬化5例;HBeAg阴性5例;3例合并糖尿病;经抗病毒治疗后病毒载量均处于低度复制或不可测状态。结论:病毒性肝炎肝硬化患者经抗病毒治疗不能完全消除原发性肝癌发生的风险,病毒载量、HBeAg阴性、糖尿病、肝硬化等可能是肝癌发生的危险因素。

Clinical Analysis of 7 Cases of Viral Liver Disease Related Hepatocellular Carcinoma during Antiviral Treatment

Objective:To explore the cause of viral liver disease related hepatocellular carcinoma during antiviral treatment.Methods:A retrospective study from October 2012 to June 2013 in Liver Disease Center of Dong Gang District Affiliated to the First Hospital of Lanzhou University was preformed. Clinical data of 7 cases that viral liver disease patients arising hepatocellular carcinoma during standard antiviral treatment were analyzed.Results:7 patients with HBV infection in 6 cases, HCV infection in 1 case. 2 cases underwent chronic hepatitis, 5 cases underwent liver cirrhosis. HBeAg negativity in 5 cases. 3 patients had diabetes. All viral replication was low or no after antiviral therapy.Conclusion:Suppression of viral replication in viral liver disease patients does not completely eliminate the risk of hepatocellular carcinoma. Viral load, HBeAg negativity, diabetes, cirrhosis may be risk factors of hepatocellular carcinoma.