Changes in perioperative level of hepatitic B virus DNA in patients with hepatocellular carcinoma and their influences / 中华肝胆外科杂志

ABSTRACT

Objective To investigate the influences in perioperative variations in serum levels of hepatitis B virus (HBV) DNA in patients with HBV-related hepatocellular carcinoma (HCC),and to observe the differences in postoperative recovery of liver function between the antiviral treatment group and the non-antiviral treatment group of patients.Methods From Feb.2012 to Nov.2012,55 patients whose preoperative serum levels of HBV DNA were below the recommended level of antiviral treatment were included into the study.The serum levels of HBV DNA,IL-6,IL-10 and IL-27 preoperatively and on postoperative day 3 were measured.Using the postoperative serum levels of HBV DNA,the patients were divided into 2 groupsthe high level group and low level group.Patients in the high level group received antiviral treatment,but the low level group did not.The changes in preoperative and postoperative liver function and other data of the patients were recorded and analyzed by the SPSS 13.0 software.Results (1) The reactivation rate of serum HBV DNA in the HBsAg-positive HCC patients was 45％ (25/55).In patients with a preoperative HBV DNA level ＜ 1 × 104 IU/ml the postoperative HBV reactivation rate was up to 76％ (19/25).(2) Logistic regression analysis showed tumor diameter (P=0.037,0.006) and injecting anhydrous alcohol into the resection margin (P=0.004) were independent risk factors of postoperative HBV reactivation.(3) Postoperative serum IL-10 elevation was associated with HBV reactivation (P=0.001).On the contrary,serum IL-6 level elevation was associated with HBV reactivation (P＜0.01).(4) When compared with the low level group,postoperative serum alanine aminotransferase,total bilirubin and albumin in the high level group showed no significant difference (P＞0.05).Conclusions Hepatectomy could reactivate HBV replication during the perioperative period.A close monitoring of HBV DNA during the perioperative period was necessary,especially in patients with low HBV DNA levels.The tumor diameter and injecting anhydrous alcohol into the resection margin were independent risk factors of postoperative increase in HBV DNA.Changes in serum IL-10 and IL-6 levels after hepatic resection might be related to the elevation of HBV DNA level.In addition,reactivation of HBV did not aggravate damages in postoperative liver function.Antiviral treatment did not promote recovery of liver function in the early stage.