Effect of entecavir antiviral therapy on the prognosis of patients with hepatitis B virus-related hepatocellular carcinoma after transcatheter arterial chemoembolization
Objective To investigate the effect of entecavir (ETV) antiviral therapy on the prognosis of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) receiving transcatheter arterial chemoembolization (TACE).Methods A total of 170 HCC patients who received TACE for the first time in Liver Cancer Center of Nanfang Hospital from January 2011 to March 2018 were enrolled, among whom 114 patients were treated with ETV (ETV treatment group) and 56 patients did not receive antiviral therapy (control group). Baseline demographic data, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), albumin (Alb), platelet count (PLT), Child-Pugh class, HBeAg and HBV DNA levels, alpha-fetoprotein, and BCLC stage were recorded before treatment, and the changes in HBV DNA level, ALT, AST, TBil, Alb, and Child-Pugh class were observed at weeks 4-8 after treatment; long-term survival was also observed after treatment. Short- and long-term clinical benefits (overall survival) were observed for all patients. The t-test or the Mann-Whithey U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. Multivariate logistic regression analyses were performed for related clinical indices before treatment to identify the risk factors for HBV reactivation. The Kaplan-Meier method was used to analyze the survival curves of overall survival, and the log-rank test was used for comparison of survival curves.Results There was no significant difference in the incidence rate of HBV reactivation between the ETV treatment group and the control group (15.79% vs 16.07%, χ2=0.002, P=0.962). The univariate analysis showed that PLT was a risk factor for HBV reactivation (Z=-2.183, P=0.029), and the multivariate analysis showed that HBV DNA level was an independent risk factor for HBV reactivation (hazard ratio =1.000, P=0.015). The 1-, 3-, and 5-year survival rates were 56.20%, 30.30%, and 13.20%, respectively, in the ETV treatment group and 60.60%, 27.20%, and 16.30%, respectively, in the control group. There was no significant difference in overall survival rate between the two groups (χ2=0.049, P=0.755).Conclusion Antiviral therapy can inhibit HBV replication after TACE in patients with HBV-related HCC, thereby reducing the hepatotoxicity of TACE.
采用甘油三酯含量测定和油红O染色方法观察肝细胞脂肪变性模型是否构建成功。结果显示油红O染色后,显微镜下观察到L02细胞组细胞质中没有大的红色脂滴,在细胞膜上存在小而均匀的红色脂滴;PA诱导的L02细胞组中细胞质内存在明显的大而深红色的脂滴(图1);与0 h比较,L02细胞在PA诱导后不同时间段甘油三酯水平有不同程度的升高(图2),表明模型构建稳定,将构建成功的脂肪变性肝细胞定义为M组进行后续研究。CCK8实验检测显示,PA诱导L02细胞24 h后细胞活性明显下降(1.000±0.084 vs 0.668±0.022,t=-18.663,P<0.001)。
Figure
6.
Changes in the expression of key molecules of FXR-PI3K/AKT pathway and PCNA and Cyclin D1 proteins in steatosis hepatocytes after inhibition of FXR expression
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