Clinical Study On The Effect Of Jinlong Capsule On HBV-DNA Of Hepatocellular Carcinoma After TACE

Objective: Transarterial arterial chemoembolization(TACE) can cause reactivation of HBV has been recognized by more and more scholars, and take various measures to prevent, treat the prognosis of patients with complications.In this study, through observe the effect on active state of hepatitis B virus deoxyribonucleic acid(HBV-DNA)and changes in life quality and immune indices of Jinlong Capsule for hepatocellular carcinoma after transcatheter arterial chemoembolization,to investigate the effects of Jinlong Capsule on HBV-DNA reactivation and the risk factors of HBV-DNA reactivation.Methods:Retrospective analysis of the clinical data of 206 cases of patients with hepatocellular carcinoma(HCC) and Hepatitis B surface antigen who received TACE in the Department of interventional radiology Cancer Hospital of Medical University Of Tianjin from 2010 June to 2014 June, according to whether the use of Jinlong Capsule,were divided into test group and control group,then according to whether the chemotherapeutic drugs were used,the test group and control group were divided into two subgroups(TAE subgroup, TACE subgroup). The test group underwent transarterial arterial embolization(TAE) or Transarterial arterial chemoembolization(TACE), on the day of TAE or TACE, start to oral Jinlong Capsule:4 capsule/time,3 times/day,30 days for 1 course, each of the patients were taking at least 2 courses. The control group was treated with TAE or TACE only. Record the HBV-DNA quantitative of the test group and the control group before and 2 months after treatment, T cell subsets(CD3+、CD4+、CD8+、CD4+/CD8+), compared the score of quality of survival before and after treatment with liver cancer specific quality of life scale.Results:1. Reactivation rate:In total, HBV reactivation occurred in 54 patients, the reactivation rate was 26.2%,17 patients in test group(reactivation rate was16.5%) and 37 patients in control group(reactivation rate 35.92%), there were a significant difference between two groups(P<0.05);compared two TAE subgroups and two TACE subgroups,there were a significant difference(P<0.05);compared TAE subgroup and TACE subgroup in test group and control group,there were no significant difference(P>0.05).2. Analysis of influencing factors of HBV reactivation:On univariate analysis, HBe Ag seropositivity(P<0.001) and HBV-DNA seropositivity(P=0.024) and use of Jinlong Capsule(P=0.002) and use of lamivudine(P=0.001) were significantly correlated with HBV reactivation, on multivariate analysis using a logistic regression analysis,HBe Ag seropositivity(OR=6.12, 95%CI:1.01-35.56, P=0.011) and HBV-DNA seropositivity(OR=8.91, 95%CI:1.14-69.95, P=0.007)were the independent predictors of HBV reactivation. Jinlong Capsule(OR=0.43, 95%CI:0.21-0.74, P=0.004) and lamivudine(OR=0.16, 95%CI:0.02-0.37, P=0.002) were protective factors of HBV reactivation.3. The influence on the immune function:In the two subgroups of test group,the CD3+、 CD4+、 CD4+/CD8+ were significantly higher than the preoperative(P<0.05),but CD8+ were not significantly changed after treatment(P>0.05); in TAE subgroup of control group,CD3+、CD4+/CD8+ decreased than preoperative(P<0.05),CD8+ were higher than preoperative(P<0.05), CD4+ no changed(P>0.05);in TACE subgroup of control group,CD3+、CD4+、CD4+/CD8+ decreased than preoperative(P<0.05),but CD8+ was higher than preoperative(P<0.05).4. The influence on the quality of life: Compared with before treatment, the physical function dimension of 4 subgroups had significant difference(P<0.05); in psychological function and social function dimensions,4 subgroups had no significant difference(P>0.05); in the aspect of symptoms/side effects of dimensions and the total score of quality of life, there were significant difference(P<0.05)except TACE subgroup of control group. Between TAE subgroups and TACE subgroups,there were significant difference in the physical function, symptoms / side effects and the total score of quality of life(P<0.05); there were no significant difference in the psychological function and social function. Compared TAE subgroup and TACE subgroup in test group and control group, had significant differences in symptoms/side effects of dimensions(P<0.05);but had no significant differences in the physical function, psychological function, social function and total score of quality of life.Conclusion:1. Jinlong Capsule can inhibit the HBV reactivation of hepatocellular carcinoma patients after TAE/TACE.2.HBV-DNA positive and HBe Ag positive are risk factors of HBV reactivation; Jinlong Capsule and lamivudine were the protective factors of HBV reactivation.Whether or not use chemotherapy drugs had no significant effect on the HBV-DNA activity status, but will reduce the life quality of the patients after TACE.3.Jinlong Capsule can improve the immune function status in patients with hepatocellular carcinoma after TAE/TACE.4.Jinlong Capsule can improve the life quality of patients with hepatocellular carcinoma after TAE/TACE.