乙型肝炎病毒表面抗原定量与肝癌的关系探讨

摘要

Objective To evaluate the significance of HBsAg in the hepatocellular carcinoma (HCC) developing from cirrhosis combined with HBV DNA level,HBeAg-positive and HBeAg-negative.Methods The titer of hepatitis B virus markers (HBV M) and the DNA capacity in HBV were detected in 306 patients with cirrhosis and HCC caused by virus infection through chemoluminescence method and fluorescent quantitation PCR technology.Results Liver cirrhosis group:the patients with serum HBsAg titers≥250 IU/ml occupied 67.5％ ;the proportion of HBeAg(+) was 23.8％ ;HBeAg(-) was 76.2％ ;HBV DNA≥ 104 copies/ml occupied 79.5％.Primary hepatocellular carcinoma in cirrhosis:the patients with serum HBsAg titers≥250 IU/ml occupied 81.9％ ;the proportion of HBeAg(+) was 38.1％ ; HBeAg (-) was 61.9％ ;HBV DNA ≥ 104 copies/ml occupied 61.3％.There were significant differences in the proportion of HBsAg≥250 IU/ml and HBV DNA ≥ 104copies/ml between two groups (P ＜ 0.05).Conclusion In the patients with liver cirrhosis due to HBV infection,long-term high-titer HBsAg plays an early warning signals role in the cirrhosis which has more possible to develop HCC.%目的 结合HBV DNA载量、HBeAg阳性与HBeAg阴性,评价HBsAg在原发性肝癌(HCC)发生、发展中的意义.方法 采用化学发光法检测306例HBV感染所致肝硬化及肝硬化合并HCC的两组患者血清乙型肝炎病毒标志物(HBV M)滴度,采用荧光定量PCR技术检测患者血清HBV DNA载量.结果 肝硬化组:血清HBsAg滴度≥250 IU/ml者占67.5％;HBeAg阳性者占23.8％;HBeAg阴性者占76.2％;HBV DNA≥104 copies/ml者占79.5％.肝硬化合并HCC组:血清HBsAg滴度≥250 IU/ml者占81.9％;HBeAg阳性者占38.1％;HBeAg阴性者占61.9％;HBV DNA≥104 copies/ml者占61.3％.两组中HBsAg≥250 IU/ml与HBV DNA≥104copies/ml病例比较差异有统计学意义(P＜0.05).结论 在HBV感染所致肝硬化患者中,长期高滴度状态的HBsAg在评价肝硬化发展为HCC中同样起到预警信号的作用.