Study On The Influence Of Hepatitis B Virus DNA Load In Serum And Liver Tissues On Peri-operative Phase And Recurrence Of Hepatocellular Carcinoma After Curative Resection

Objective:1. To investigate the influence of serum hepatitis B virus DNA(HBV-DNA) load on hepatocellular carcinoma(HCC) patients infected HBV during peri-operative phase.2. To investigate the influence of serum HBV-DNA load on tumor recurrence of H- CC patients after their curative resection.Especially those patients who are negative f- or serum HBV-DNA may have high levels of HBV-DNA load in their liver tissues.To investigate the influence of HBV-DNA load in liver tissues on tumor recurrence of H- CC patients after their curative resection.Methods:1. The preoperative and one week postoperative serum HBV-DNA level and ALT of liver function were measured in 53 HBV related HCC patients.To observe and rec- ord their complications and the change of postoperative liver function.2. According to our protocol,40 patients with HCC who hospitalized in our hospital were selected as experimental group from January 2007 to September 2007 ,and were divided into HBV-DNA negative group(E-NB group) and positive group(E-PB group) according to their viral load in preoperative serum.The value of serum HBV-DNA fr- om the patients was lower than n×103IU/ml,the patients were assumed to be negative group.There were 20 cases in each group,respectively.Fluorescence quantitative Poly- merase Chain Reaction(PCR) was used to detect HBV-DNA in preoperative peripher- al blood,distant liver tissues,adjacent liver tissues and tumor tissues of the HCC patie- nts.Collect 20 non-HCC cases whose hepatitis B markers are all negative as first cont- rol group(FC group),and 40 non-HCC cases whose HBsAg are positive as second co- ntrol group(SC group).The 40 non-HCC cases in SC group were divided into HBV- DNA negative group(SC-NB group) and positive group(SC-PB group) according to v- iral load.There were 20 cases in each group,respectively.3. The 40 curative HCC patients were divided into HBV-DNA negative group(FU- NB) and positive group(FU-PB) according to their viral load in preoperative serum.T- he value of serum HBV-DNA from the patients was lower than n×103IU/ml,the patie- nts were assumed to be negative group.The tumor recurrence rate in the two groups were observed and compared.The 40 curative HCC patients were divided into high or low group according to their viral load in adjacent liver tissues.The value of HBV- DNA load in 50 millgram of adjacent liver tissues from patients was lower than n×105 IU/ml,the patients were assumed to have low viral load.The tumor recurrence rate in the two groups were observed and compared.Results:1. The level of serum HBV-DNA between pre- and post-operative peripheral blood of HCC patients was no significant difference(P>0.05).2. The recovery period of liver function was significantly extended in those patients who had high level of serum HBV-DNA load,and their incidence of complication was significantly increased as well. The preoperative serum HBV-DNA level was signific- antly positive correlated with the recovery period of liver function and incidence of c- omplication after hepatectomy(P<0.05).3. HBV-DNA was detected in one of 20 hepatic tissues in FC group. HBV-DNA w- as not detected in one of 20 hepatic tissues in SC-NB group,and was detected in all 20 hepatic tissues in SC-PB group. The HBV-DNA load of normal hepatic tissues in SC- NB and SC-PB group were significantly higher than that of peripheral blood(P<0.05). HBV-DNA was detected in all distant liver tissues, adjacent liver tissues and tumor ti- ssues of 40 HCC patients in experimental group. The HBV-DNA load of distant liver, adjacent liver and tumor tissues in E-NB and E-PB group were all significantly higher than that of peripheral blood(P<0.05).4. The HBV-DNA load of adjacent liver tissues in E-NB and E-PB group were both significantly higher than that of normal liver tissues in SC-NB, SC-PB and FC group (P<0.05). 5. During the one year and half follow-up period, there were 12 recurrent cases am- ong 40 HCC patients.The tumor recurrence rate was 20% for FU-NB group and 40% for FU-PB group(P>0.05),and was 52.94% for high group and 13.04% for low group (P<0.05).Conclusions:1. The hepatectomy would not stimulate HBV to engage in active replication.2. The high level of serum HBV-DNA in HCC patients' preoperative peripheral blo- od would result in the extend of liver function recovery and increasing the incidence of complication after hepatectomy.3. The hepatic dysfunction of hepatectomy is mainly attributed to surgical trauma during perioperative phase, and is little related to the level of serum HBV-DNA.4. The detection of HBV-DNA in liver tissues of HCC patients who were negative for serum HBV-DNA would be better for us to learning the duplicating status of HBV in their liver than detection in peripheral blood,so that it can direct their anti-viral the- rapy and evaluate its efficacy.5. There was a close relationship between high levels of HBV-DNA load and incid- ence of HCC.During short-term follow-up period,level of serum HBV-DNA was no r- elated with tumor recurrence after HCC patients' curative resection.But high level of HBV-DNA load in adjacent liver tissues was positively related with tumor recurrence rate.