ABSTRACT
Objective:To analyze the effect of different hepatitis B virus DNA (HBV DNA) loading on liver function in patients with hepatitis B-related hepatocellular carcinoma (HCC).Methods:From February 2017 to August 2018, 78 patients with HCC who underwent radical hepatectomy in the Second Affiliated Hospital of Guangxi University of Science and Technology were enrolled retrospectively.According to the difference of preoperative serum HBV DNA load, there were 30 cases in the high copy group and 48 cases in the low copy group.The positive rates of HBV DNA load in patients with hepatocellular carcinoma were compared 3 days before operation, 7 days and 6 months after operation.Repeated measurement ANOVA was used to observe the liver function of the two groups 3 days before operation, 7 days and 6 months after operation, and the adverse reactions of the two groups were compared.Results:There was no significant difference in the positive rate of HBV DNA load between 3 days before operation, 7 days after operation and 6 months after operation ( P>0.05). The levels of alanine aminotransferase in high copy group were (60.25±28.22), (201.35±69.12), (250.52±74.76) U/L 3 days before operation, 7 days and 6 months after operation, and those in low copy group were (57.24±20.83), (144.50±49.25), (200.21±51.66) U/L.The results of repeated measurement ANOVA showed that Fintra-group=20.429, P<0.01, Finter-group=7.119, P<0.01, Finteraction=27.547, P<0.01.There were significant differences between 7 days, 6 months and 3 days before operation (all P<0.01), between 7 days and 6 months after operation (all P<0.05), and between 7 days and 6 months after operation (all P<0.05). The aspartate aminotransferase levels were (53.14±24.23), (300.30±63.85), (352.36±60.38) U/L in the high copy group 3 days before operation, 7 days and 6 months after operation, and (57.74±23.13), (232.56±53.08), (254.56±58.78) U/L in the low copy group.The results of repeated measurement ANOVA showed that Fintra-group=41.476, P<0.01, Finter-group=50.211, P<0.01, Finteraction=8.736, P<0.01.The difference between 7 days and 6 months after operation and 3 days before operation within the group was statistically significant (all P<0.01). The difference between 7 days after operation and 6 months after operation was statistically significant (all P<0.05). There were statistically significant differences between the groups at 7 days and 6 months after operation (all P<0.05). The plasma albumin of high copy group was (38.13±13.14), (24.22±8.56), (20.31±5.37) g/L 3 days before operation, 7 days and 6 months after operation, and that of low copy group was (37.93±12.54), (29.77±9.32), (25.32±6.43) g/L.The results of repeated measurement ANOVA showed that Fintra-group=12.836, P<0.01, Finter-group=3.608, P<0.05, Finteraction=16.444, P<0.01.There were significant differences between 7 days, 6 months and 3 days before operation (all P<0.01), between 7 days and 6 months after operation (all P<0.05), and between 7 days and 6 months after operation (all P<0.05). The total bilirubin of high copy group was (27.56±6.12), (37.78±9.45), and (46.56±10.22)% at 3 days before surgery, 7 days and 6 months after surgery, and that of low copy group was (25.82±6.38), (31.11±8.65), (38.26±9.23)%, respectively.The results of repeated measurement ANOVA showed that Fintra-group=10.281, P<0.01, Finter-group=8.832, P<0.01, Finteraction=19.114, P<0.01.There were significant differences between 7 days, 6 months and 3 days before operation (all P<0.01), between 7 days and 6 months after operation (all P<0.05), and between 7 days and 6 months after operation (all P<0.05). In addition, the recovery time of liver function in the high copy group was (13.22±2.21) d, and that in the low copy group was (10.34±2.53) d. The difference between the two groups was statistically significant ( t=5.128, P<0.01). The incidence of adverse reactions was 46.67% (14/30) in the high copy group and 16.67% (8/48) in the low copy group, and the difference was statistically significant ( P=0.008). Conclusion:There was no significant change of HBV DNA load in HCC patients before and after operation, while the recovery ability of liver function in HCC patients with high copy HBV DNA was significantly reduced, the incidence of adverse reactions was higher, and the prognosis was poor.
ABSTRACT
Objective To analyze the dynamic changes of immunoregulatory factors and tumor markers before and after chemotherapy in patients with advanced gastric cancer.Methods From October 2015 to February 2018,58 patients with chemotherapy AGC in our hospital were selected as gastric cancer group.According to the efficacy of chemotherapy they were divided into effective group, stable group and ineffective group.Meanwhile,30 healthy persons were selected as normal group.The immunoglobulins (IgA, IgG,IgM), T lymphocyte subsets ( CD3+, CD4+, CD8+, CD4+／CD8+) and related tumor markers ( CEA, CA199,CA242) were compared before and after chemotherapy.Results The levels of IgA((2.11±0.89) g／L),IgM((10.65±4.61) g／L),IgG((1.25±0.45) g／L),CD8+((28.12±3.56)%),CEA((40.33 ±16.24) μg／L),CA199((76.34±21.56) kU／L) and CA242((29.34±9.57)k U／L) in the gastric cancer group were significantly higher than those in the normal group IgA((0.93±0.36) g／L),IgM((6.46±3.59) g／L),IgG((0.65±0.32) g／L),CD8+(( 25.02± 4.78)%),CEA((1.81± 0.55) μg／L),CA199((7.51 ±2.67) kU／L),CA242((3.35±1.21) kU／L) (t＝6.958,3.600,6.495,3.435,12.952,17.370,14.773, P＜0.05),while CD3+(( 64.12± 5.12)%),CD4+(( 34.12 ± 4.10)%),CD4+／CD8+( 1.09 ± 0.28) were lower than the normal group (CD3+(71.23±7.14)%,CD4+( 39.78±5.20)%,CD4+／CD8+( 1.47±0.40)) (t＝5.376,5.592,5.192,P＜0.05).The total effective rate of AGC patients in gastric cancer group was 79.31 %(46／58),and the ineffective rate was 20.69%(12／58).IgA,IgG,IgM,and CD8+in the effective group were significantly lower than those before chemotherapy (t＝3.925,3.745,4.036,2.661,P＜0.05), while CD3+,CD4+, CD4+／CD8+ were significantly higher than before chemotherapy ( t＝3.520, 3.077, 3.218,P＜0.05).The subcellular level of protein and T lymphocytes was significantly better than that of stable group and ineffective group (P＜0.05).The levels of tumor markers CEA,CA199 and CA242 in the effective group and stable group were significantly lower than those before chemotherapy ( P＜0.05), and significantly lower than the ineffective group ( P＜0.05).Conclusion The levels of immunoglobulins, T lymphocyte subsets and tumor markers in patients with AGC have significant changes after chemotherapy,and their levels can guide the efficacy of chemotherapy.