乙型肝炎病毒感染与B细胞型非霍奇金淋巴瘤的关系．  

Relationship between hepatitis B virus infection and B-cell non-Hodgkin lymphoma

作　　者：林雯 林英城 王鸿彪 林文照 林穗玲 李蔚冰[2] 

机构地区：[1]大学医学院附属肿瘤医院内科,汕头515000 [2]汕头市中心医院肿瘤内科

出　　处：《肿瘤研究与临床》2012年第1期28-30,共3页Cancer Research and Clinic

摘　　要：目的探讨B细胞型非霍奇金淋巴瘤（NHL）与乙型肝炎病毒（HBV）之间的关系。方法统计2003年1月至2009年12月住院的284例B细胞型NHL患者的乙肝5项标志物阳性率，并与同期住院的大肠癌患者作比较。结果B细胞型NHL以18—39岁和Ⅲ一Ⅳ期患者乙型肝炎表面抗原（HBsAg）阳性率较高，分别为42．6％（26／61）和37．0％（50／135），分别与其他年龄段及I一Ⅱ期患者比较，差异均有统计学意义（x。值分别为7．573和6．874，P值分别为0．023和0．009）；B细胞型NHL患者HBsAg、乙型肝炎e抗原（HBeAg）的阳性率较大肠癌患者高[29．6％（84／284）比14．5％（155／1070），6．7％（19／284）比0．8％（9／1070），Wald值分别为25．174和20．496，P值均为0．0011；乙型肝炎表面抗体（抗HBsAb）阳性率较大肠癌患者低『45．4％（129／284）比58．0％（621／1070），waid=11．062，P=0．0011；HBsAg、HBeAg及乙型肝炎核心抗体（抗HBcAb）同时阳性和HBsAg、乙型肝炎e抗体（抗HBeAb）及抗HBcAb同时阳性的发生率较大肠癌患者高『6．0％（17／284）比0．8％（9／1070），16-2％（46／284）比11．5％（123／1070），x0值分别为31．619和4．542，P值分别为0．000和0．033]；抗HBcAb阳性且抗HBsAb阴性的发生率也较大肠癌患者高[37．0％（105／284）比24．5％（262／1070），Wald=17．708，P〈0．001]；抗HBcAb和抗HBsAb同时阳性的发生率较大肠癌患者低『20．8％（59／284）比27．8％（297／1070），Wald=5．646，P=0．017]。结论HBV感染和B细胞型NHL存在一定相关性，HBV感染可能在B细胞型NHL的病原学中起作用。Objective To evaluate the association between B-cell non-Hodgkin lymphoma （NHL） and hepatitis B virus （HBV）. Methods The positive rates of HBV markers in 284 patients of B-cell NHL who were admitted to our department between January 2003 and December 2009 were investigated. The positive rates of HBV markers in colorectal cancer patients were used as controls. Results The HBsAg-positive rates of patients aged 18~ 39 and stage Ill/IV patients were 42.6 % （26/61） and 37.0 % （50/135）, which was higher than other groups. The X2 value and P value were 7.573 and 6.874, 0.023 and 0.009, respectively. Compared with the control group, the B-cell NHL had significantly higher prevalence of positive HBsAg and positive HBeAg （29.6 % vs 14.5 %, 6.7 % vs 0.8 % ）. The Wald values were 25.174 and 20.496, respectively. Both of the P value were 〈0.001 and lower prevalence of positive anti-HBs （45.4 % vs 58.0 %, Wald =11.062, P = 0.001）. The coexpression of HBsAg, HBeAg and anti-HBc was higher in the B-NHL group than in the control group （6.0 % vs 0.8 %, X2 = 31.619, P 〈0.001）. Similarly, the eoexpression of HBsAg, anti-HBe, and anti-HBc was higher in the B-NHL group （16.2 % vs 11.5 %, X2 = 4.542, P = 0.033）. Significantly higher rate of positive anti-HBc and negative anti-HBs was observed in the B-NHL group （37.0 % vs 24.5 %, Wald --- 17.708, P 〈 0.001）, whereas the same group showed a lower rate of negative anti-HBs compared with the control group （20.8 % vs 27.8 %, Wald = 5.646, P = 0.017）. Conclusion This finding of a positive association between HBV infection and B-NHL suggests that HBV may play an etiologic role in the induction of B-NHL.

关 键 词：淋巴瘤 非霍奇金 肝炎病毒 乙型 感染 

分 类 号：R735[医药卫生—肿瘤] R733[医药卫生—临床医学] R51