BACKGROUND: The aim of this study was to
investigate the reactivation of the hepatitis B
virus (HBV) following transarterial chemoembolization (TACE) in primary hepatocellular carcinoma(HCC) patients with HBV-DNA negative and to evaluate the effects of TACE combined with antiviral therapy.
METHODS: This prospective study involved 98 patients with HBV-relatedand HBV-DNA negative HCC (HBV DNA < 10 copies/mL) underwent TACE
procedures with serial HBV DNA tests. Patients were divided into the antiviral treatment group and the no-antiviral group. The antiviral group received entecavir antiviral therapy, and the
other group received no antiviral therapy.Two groups of patients were compared in rate of HBV reactivation and liver function before and after only 1 session of TACE in
average 1-month follow-up after operation. P < .05 indicated differences
with a statistical significance.
方法：这项前瞻性研究纳入98名HBV相关性且HBV-DNA阴性(HBV DNA < 10 copies/mL)的肝癌患者，患者均接受TACE治疗和连续的HBV DNA检测。患者被分为抗病毒治疗和无抗病毒治疗组。抗病毒治疗组接受恩替卡韦抗病毒治疗，另一组无抗病毒治疗。在TACE治疗前以及治疗一段时间后（平均术后1个月内），对比两组间的HBV再活化率及肝功能。P＜0.05被认为有统计学差异。
RESULTS: HBV reactivation occurred in 11 patients in the nonantiviral group
(11/47, 23.4%) but only 3 patients in the antiviral group (3/51, 5.9%, P < .05). On
multivariate analysis, HBeAg-positive status, number of tumors more than 3, and
absence of antiviral therapy were the independent risk predictor of HBV reactivation. Liver function indicators did not differ significantly between
the antiviral group and the nonantiviral group in
5 days after TACE. However, the level of alanine aminotransferase and
bilirubin were raised and albumin was reduced at the HBV reactivation group compared with no HBV reactivation group
(P < .05). At 1 month after TACE, liver function indicators did not differ significantly between
the HBV reactivation group and without HBV reactivation group.
结果：无抗病毒治疗组和抗病毒治疗组分别有11人(11/47, 23.4%)和3人(3/51, 5.9%, P <0 .05)出现HBV再活化。多因素分析显示，HBeAg阳性，肿瘤数目＞3个，无抗病毒治疗是HBV再活化的独立预测因子。TACE术后5天两组的肝功能指标无显著差异。但是，HBV再活化组的ALT和胆红素水平较无HBV再活化组显著提高，白蛋白水平显著下降（P＜0.05）。TACE后1个月时，有无抗病毒治疗的两组肝功能指标无显著差异。
CONCLUSION: HCC patients with HBV DNA negative still remain associated with risk of HBV reactivation after TACE. HBeAg-positive, number of
tumors more than 3, and absence of antiviral therapy in HCC patients after TACE have a higher risk of HBV reactivation. Antiviral therapy can reduce the risk of reactivation,
helping improve liver function after TACE.
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