乙型肝炎病毒感染标志物与肝癌关系的前瞻研究  

A Prospective Study of the Relationship between Hepatitis B Virus Markers and Primary Liver Cancer

作　　者：孙燕[1] 陆培新[1] 王金兵[1] 吴燕[1] 张启南[1] 陈陶阳[1] 

机构地区：[1]江苏启东肝癌防治研究所,226200

出　　处：《天津医药》2010年第2期81-83,共3页Tianjin Medical Journal

基　　金：国家"八五";"九五"重点科技攻关课题基金资助项目(项目编号:859140303;969060107)

摘　　要：目的:探讨患者携带乙型肝炎表面抗原(HBsAg)与发生肝癌的关系。方法:在肝癌高发的启东地区,对515例20～60岁男性HBsAg携带者作乙型肝炎病毒感染标志物HBsAg、HBsAb、HBeAg、HBeAb、HBcAb(HBVM1、2、3、4、5)检测,进行连续20年的队列研究。结果:队列发生肝癌111例,肝癌发生率为1340.90/10万人年,肝癌发生中位年龄为43岁,平均生存期为1年3个月,41～50岁年龄组的肝癌发生率高于其他年龄组(P<0.05)。队列HBVM以15、135、145为主要模式,分别占队列的38.83%(200/515)、15.92%(82/515)、44.08%(227/515),此3种模式的肝癌发生率分别为1433.69/10万人年、2284.71/10万人年、984.10/10万人年,135模式显著高于145模式(P<0.01)。肝癌中15、135、145模式分别占39.64%(44/111)、23.42%(26/111)、35.14%(39/111),15模式显著多于135模式(P<0.01)。肝硬化死亡率分别为195.50/10万人年、966.61/10万人年和277.57/10万人年,135模式显著高于15、145模式(P<0.01)。结论:HBsAg携带者是发生肝癌的高危人群,对其进行定期随访,能早期发现肝癌患者,给予早期治疗后可延长肝癌患者生存期。HBV复制程度与肝癌发生有关,通过抗病毒治疗等手段可能会延缓或解除肝癌的发生。Objective：To study the relationship between hepatitis B surface antigen（HBsAg） and the primary liver cancer （PLC）.Methods：A 20-year prospective follow-up study was performed continuously in Qidong on a cohort of 515 HBsAg positive male patients aged 20-60 years old.The markers of hepatitis B virus,HBsAg,HBsAb,HBeAg,HBeAb and HBcAb （HBVM 1,2,3,4,5） were detected at the first time of the follow-up.Results：The PLC incidence of the whole cohort was 1 340.90/100 000 person years（PY）.The middle age of the PLC diagnosis was 43 with an average survival of 15 months.The PLC incidence was significantly higher in 41-50 age group than that of other age groups（P〈0.05）.The three major HBVM patterns were 15,135 and 145 in the cohort with percentages of 38.83%（200/515）,15.92%（82/515）and 44.08%（227/515） respectively.The PLC incidences of these three patterns were 1 433.69/100 000 PY,2 284.71/100 000 PY,984.10/100 000 PY respectively,showing a significant difference between 135 and 145 （P〈0.01）.The percentages of 15,135 and 145 were 39.64%（44/111）,23.42%（26/111） and 35.14%（39/111） in PLC patients respectively,showing a significant difference between 15 and 135 （P〈0.01）.The liver cirrhosis mortality of those three patterns were 195.50/100 000 PY,966.61/100 000 PY and 277.57/100 000 PY respectively,showing the significant differences between 135 and other two patterns （P〈0.01）.Conclusion：HBsAg carriers were high risk population of PLC.The regular following-up is helpful on early diagnosis and treatment of PLC in those people,and can prolong the survival time.It was found that 135 had higher PLC risk than other HBVM patterns,suggesting a relationship between HBV duplication and PLC.The anti-virus treatment may delay or remove the occurring of PLC.

关 键 词：肝肿瘤 肝炎病毒 乙型 前瞻性研究 癌 生物学标记 

分 类 号：R512.62[医药卫生—内科学]