慢性乙型病毒性肝炎炎症损伤程度与肝细胞癌发生的相关性研究  

Study on the relationship between the degree of inflammatory injury and the occurrence of hepatocellular carcinoma in patients with chronic hepatitis B

作　　者：李文[1] 赵静媛 毛云华 张昊[1] 陈署贤[1] 潘楚芝[1] 徐见亮[1] 潘卫东[1] 

机构地区：[1]中山大学附属第三医院肝胆外科,广州510630 [2]广东省肝病研究重点实验室

出　　处：《中华肝脏外科手术学电子杂志》2017年第2期118-122,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：国家自然科学基金(81172783)

摘　　要：目的探讨慢性乙型病毒性肝炎(乙肝)的炎症损伤程度与肝细胞癌(肝癌)发生的相关性。方法回顾性分析2004年1月至2014年10月在中山大学附属第三医院接受诊治且随访资料完整的1 608例慢性乙肝患者临床资料。其中男1 292例,女316例;年龄11~73岁,中位年龄35岁。患者均签署知情同意书,符合医学伦理学规定。所有患者均接受肝穿刺活检,根据肝组织炎症损伤程度将患者分为G1、G2、G3和G4组。观察不同炎症分级患者肝癌发生率和构成比。率的比较采用χ~2检验。结果所有患者的肝组织穿刺标本病理学检查结果均显示一定程度的炎症损伤,其中肝组织炎症损伤分级G1组占36.94%(594/1 608),G2组占32.09%(516/1 608),G3组占22.82%(367/1 608),G4组占8.15%(131/1 608)。至随访截止共有38例肝癌发生,发生率为2.36%(38/1 608),其中G1组0.34%(2/594),G2组2.32%(12/516),G3组5.72%(21/367),G4组2.29%(3/131)。随着肝组织炎症损伤程度的加重,患者肝癌发生率增加,G3组患者的肝癌发生率明显高于G1、G2组(χ~2=28.16,6.88;P<0.05)。不同程度肝组织炎症损伤的患者发生肝癌的比例不同,G1和G2组、G1和G3组、G1和G4组、G2和G3组之间差异均有统计学意义(χ~2=8.77,28.16,5.98,6.88;P<0.05)。结论随着损伤炎症程度的加重,慢性乙肝患者发生肝癌的风险增高。Objective To investigate the relationship between the degree of inflammatory injury and the occurrence of hepatocellular carcinoma （HCC） in patients with chronic hepatitis 13. Methods Clinical data of 1 608 patients with chronic hepatitis B who admitted to the Third Affiliated Hospital of Sun Yat-sen University between January 2004 and October 2014 were retrospectively analyzed. And all the follow-up data of the patients were complete. Among them, 1 292 were males and 316 were females, aged from 11 to 73 years old with a median age of 35 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. Liver biopsy was performed on all patients. According to the degree of liver inflammatory injury, the patients were divided into G1, G2, G3 andG4 groups. The incidence and constituent ratio of HCC in four groups were observed. The ratio was compared using Chi-square test. Results Pathological examination showed that certain degree of inflammatory injury in the liver tissues were observed in all patients. Among the patients, 36.94% （594/1 608） were classified into the G1 group, 32.09% （516/1608） into the G2 group, 22.82% （367/1608） into the G3 group and 8.15% （131/1608） into the G4 group. Thirty-eight cases of HCC occurred during the follow-up with the incidence of 2.36% （38/1 608）, including 0.34% （2/594） in G1 group, 2.32%（12/516） in G2 group, 5.72% （21/367） in G3 group and 2.29% （3/131） in G4 group. The incidence of HCC increased as the aggravation of the inflammatory injury degree in liver tissues. The incidence of HCC in G3 group was significantly higher than that in G1 group and G2 group （χ22=28.16, 6.88; P〈0.05）. The constituent ratio of HCC was different in each groups, and significant differences were observed between G1 group and G2 group, G1 group and G3 group, G1 group and G4 group, and G2 group and G3 group （χ22=8.77, 28.16, 5.98, 6.88; P〈0.05）. Conclusion The risk of the occurrence of HCC in patien

关 键 词：肝炎  乙型 癌  肝细胞 炎症 

分 类 号：R512.62[医药卫生—内科学]