HBeAg与乙型肝炎相关性肝细胞癌关系的临床观察

杨志勇; 杨茜; 肖贵宝; 赵贺红; 冯萍

HBeAg与乙型肝炎相关性肝细胞癌关系的临床观察

1. 四川大学华西医院感染科
2. 四川大学华西公共医学院
3. 四川大学华西医院感染性疾病中心

详细信息

中图分类号: R512.62
计量
- 文章访问数: 3616
- HTML全文浏览量: 4
- PDF下载量: 704
- 被引次数: 0
出版历程
- 出版日期: 2012-04-20

Clinical observation of the relation between the HBeAg and HBV-related hepatocellular carcinoma

摘要

摘要: 目的研究HBeAg阴性与HBeAg阳性的乙型肝炎相关性原发性肝癌患者生化指标和病毒相关因素的差异,并探讨其临床意义。方法回顾性分析华西第一附属医院2009年1月～2010年11月以来住院的合并HBV感染原发性肝癌患者220例,分为HBeAg阳性与HBeAg阴性两组。探讨两组甲胎蛋白(AFP)水平、肝功能水平,HBV DNA定量、肝组织学指标的差异。结果HBeAg阳性原发性肝癌195例,占总数的89%;HBeAg阴性原发性肝癌25例,占总数的11%;HBeAg阳性组HBVDNA定量对数均值显著高于HBeAg阴性组(t=2.01,P<0.05);HBeAg阴性组肝纤维化分期为4期的比例为40%,明显高于HBeAg阳性组21%(χ2=9.5,P=0.049)。两组在AFP,肝功能等指标上差异无统计学意义。结论 HBeAg阳性原发性肝癌发生率高于阴性者。同HBeAg阳性原发性肝癌相比,HBeAg阴性肝癌患者肝组织学损害程度较重,合并肝硬化更为常见,预后更差。HBeAg阴性患者并发肝细胞癌,早期漏诊率高于阳性者。
- 肝炎,乙型,慢性 /
- 肝炎e抗原,乙型 /
- 癌,肝细胞 /
- 肝炎病毒,乙型
Abstract: Objective To study the virus-related factors, biochemical differences in the HBeAg-negative and HBeAg-positive patients with primary liver cancer, and to explore the clinical significance.Methods Retrospective analysis of merger of 220 cases of hospitalized HBV infection with primary liver cancer in the First Affiliated Hospital of West China from January 2009 to November 2010, and were divided into HBeAg-positive and HBeAg-negative groups.Analysis of AFP level, liver function levels, HBV DNA quantitative, targets liver histology differences of the two groups were made.Results 195 cases of HBeAg-negative primary liver cancer accounting for 89%;25 cases of HBeAg-positive hepatocellular carcinoma, accounting for 11%.HBeAg-positive group HBV DNA quantitative was significantly higher than the mean of the number of HBeAg negative group (t= 2.01, P<0.05) ;HBeAg-positive group stage four liver fibrosis ratio of 32%, was significantly higher than the HBeAg negative group of 21% (χ2= 9.5, P= 0.049) .The AFP level and other indicators of liver function of the two groups had no statistically significant difference.Conclusion The incidence of HBeAg-positive HCC was higher than that of HBeAg-negative, which was inconsistent with the domestic Zou Chuanxin report.Compared with HBeAg-negative primary liver cancer, liver damage in HBeAg-positive patients was commonly observed with severe liver histology, combined with portal cancer, and cirrhosis of the liver and making the prognosis even worse.HBeAg-negative patients with hepatocellular carcinoma was higher than the HBeAg-positive.
- hepatitis B /
- chronic /
- hepatitis B e antigens /
- carcinoma

HTML全文

参考文献(10)

[1]王金桃, 赵宏光, 赵淑芳, 等.山西省原发性肝癌、丙型肝炎病毒、乙型肝炎病毒感染状况分析[J].中华流行病学杂志, 1999, 20 (13) :215-217

[2]何泽宝, 朱坚胜, 蔡修熙, 等.甲胎蛋白与肝炎病毒关系研究[J].中华传染病杂志, 2001, 19 (3) :176-177.

[3]Funk ML, Rosenberg DM, Lok AS.World-wide epidemiology ofHBeAg-negative chronic hepatitis B and associated precore andcorepromoter variants[J].J Viral Hepat, 2002, 9 (1) :52-61.

[4]Gravina P.Impact of storage conditions on genetic analysis orviral load determination in clinical specimens[J].Clin ChemLab Med, 2008, 46 (2) :280-282.

[5]Chen CH.Hepatitis B virus genotype B results in better im-mediate, late and sustained responses to peginterferon-alfain hepatitis-B-e-antigen-positive patients[J].J Gastro-enterol Hepatol, 2011, 26 (3) :461-468.

[6]代维.李志清, 姜红峰, 等.血清AFP、CA199、CA125、CEA、r-GT联合检测对原发性肝癌的诊断价值[J].华中医学杂志, 2007, 31 (2) :143-144.

[7]徐海峰, 杨华瑜, 张宏冰, 等.改变肝癌早期诊断和治疗现状的新肝癌血清标志物[J].基础医学与临床, 2008, 28 (1) :104-108.

[8]凡创, 曹浩强, 金利民.多项肿瘤标志物联合检测对肝癌诊断的临床应用[J].中国实验诊断学, 2004, 8 (3) :255-256.

[9]邹传鑫, 聂家燕, 戴绍军, 等.HBeAg阴性与阳性原发性肝癌临床和病毒相关因素分析[J].世界华人消化杂志, 2008, 32 (16) :3696.

[10]李静缓, 刘立新.乙型肝炎e系统与肝癌的关系研究进展[J].临床消化病杂志, 2008, 20 (1) :61-62.

施引文献

资源附件(0)

访问统计