关键词: 术后恢复, 肝细胞癌, 丙型肝炎病毒, 乙型肝炎病毒, 术后复发

Abstract: 【Abstract】〓Objective〓To investigate the role of hepatitis B virus (HBV) and hepatitis C virus (HCV) in clinicopathological features and pro gnosis of patients with hepatocellular carcinoma (HCC). Methods〓A retrospective analysis of clinicopathological data were performed in 355 patients with hepatocellular carcinoma who received hepatic resection in our hospital from 1995 to 2000. There were 163 HBV-related HCC patients included into HBV group and 73 HCV-related HCC patients included into HCV group,the other 119 non-HBV and non-HCV-related HCC patients were also included as control group (NBNC group). The impact of hepatic virus on clinicopathological features and prognosis of hepatocellular carcinoma were analyzed. Results〓HBV-HCC patients was characterized by young age, high male/ female ratio and high (AFP) level. HCV-HCC patients were associated with old age,low serum albumin level,high serum ALT level,and early-stage tumor. NBNC HCC were characterized by large tumor size,high incidence of vascular invasion and incomplete capsule since fewer NBNC-HCC patients received regular follow-up for liver diseases and hepatic tumors might be detected only after symptoms occurred. Median survival time for HBV-HCC and HCV-HCC were fifteen months and nineteen months. 1-, 3-, 5-, 7-, over all survival rates were 71.0%, 34.0%, 30.7%, 11.53% for HBV-HCC respectively and 90.3%,68.2%,41.9%, 31.41% respectively for HCV-HCC,respectively. The result suggested HCV-HCC patients had a longer survival time and better outcome than HBV-related patients(V2=10.92,P<0.001). Multivariate regression analysis showed the type of hepatic virus was a dependent of influential factors of prognosis. The post-operative death risk of HCC patients with hepatitis B virus was 1.5 times higher than that of the HCC patients without hepatitis virus infection (P=0.03), while the death risk of HCC patients with hepatitis C virus was 0.85 times lower than that of NBNC patients (P=0.58). Conclusion〓Significant difference existed in clinicopathlogical features and surgical outcome between HCC patients with hepatitis B virus and hepatitis C virus infections. HCV-related HCC patients can obtain a better surgical outcome compared to those with HBV-related hepatocellular carcinoma.

Key words: Hepatocellular carcinoma, Hepatitis B virus, Hepatitis C virus