Clinical study of hepatitis B virus reactivation in patients with hepatitis B-related liver cancer after receiving transcatheter arterial chemoembolization therapy / 介入放射学杂志

ABSTRACT

Objective To investigate the factors influencing hepatitis B virus (HBV) reactivation in patients with HBV-related liver cancer after receiving transarterial chemoembolization (TACE) in order to prevent HBV reactivation and liver function damage, and to improve the clinical ways and means of TACE to provide reliable basis for the further improvement of curative effect. Methods A total of 80 patients with HBV-related liver cancer, who were admitted to authors' hospital during the period from January 2015 to August 2016, were collected. The gender, age, preoperative liver function classification, preoperative HBV DNA load, portal vein tumor thrombus, number of tumor lesions, the amount of used gelatin sponge, the amount of used microsphere, and the amount of lipiodol used in operation, etc. were recorded, and the results were statistically analyzed. Results Single factor analysis showed that higher preoperative HBV DNA load, the large amount of lipiodol used in operation and the presence of portal vein tumor thrombus were significantly related to the reactivation of HBV, but other factors had no significant relationship with the reactivation of HBV. Multivariate analysis indicated that higher preoperative HBV DNA load and the used dosage of lipiodol in operation >10 ml were the greatest risk factors for reactivation of HBV. Conclusion Reactivation of HBV in patients with HBV-related liver cancer can be induced by TACE, especially in the patients who have higher preoperative HBV DNA load and portal vein tumor thrombus, and also in whom the dosage of lipiodol used in operation is larger. Therefore, in order to prevent HBV reactivation and liver function injury the indications and contraindications of TACE should be strictly observed, the active antiviral therapy should be adopted before and after TACE, and the amount of lipiodol should be strictly controlled during the operation.