HCV基因型、AFP与P53抗体、ANA在HCV相关肝细胞癌中的相关性  

Correlation of HCV genotype, AFP and P53 antibody, ANA in HCV-related hepatocellular carcinoma

作　　者：杨自力[1] 张洁[1] 陈娟娟 任皓月 万祎[2] YANG Zi-li;ZHANG Jie;CHEN Juan-juan;REN Hao-yue;WAN Yi(Department of Clinical Laboratory,the Third Hospital of Mianyang,Sichuan Mental Health Center,Mianyang,Sichuan 621000;Department of Hepatobiliary Surgery,the Third Hospital of Mianyang,Sichuan Mental Health Center,Mianyang,Sichuan 621000,China)

机构地区：[1]绵阳市第三人民医院(四川省精神卫生中心)检验科,四川绵阳621000 [2]绵阳市第三人民医院(四川省精神卫生中心)肝胆外科,四川绵阳621000

出　　处：《热带医学杂志》2021年第9期1134-1138,共5页Journal of Tropical Medicine

基　　金：四川省卫生和计划生育委员会科研课题(18PJ111)。

摘　　要：目的探讨丙型肝炎病毒(HCV)相关肝细胞癌(HCV-HCC)患者HCV基因型、甲胎蛋白(AFP)与P53抗体、抗核抗体(ANA)的相关性及临床病理分析。方法选取2016年1月-2020年6月于绵阳市第三人民医院确诊的HCV-HCC患者100例。分别采用PCR-反向点杂交技术、ELISA方法、电化学发光法、间接免疫荧光(ⅡF)检测HCV基因型、P53抗体、AFP、ANA。比较不同AFP分组中HCV基因型、P53抗体、ANA结果分布的差异,分析HCV基因型、AFP与P53抗体、ANA的相关性;比较HCV基因型、AFP、P53抗体、ANA在不同HCV-HCC病理特征中的阳性率。结果HCV 1b型HCV-HCC患者的P53抗体、AFP及ANA分布结果明显高于非1b型患者(Z=-3.741、-6.846、-5.042,P均<0.001)。按AFP阴性(AFP<8.1 ng/mL)及AFP阳性(AFP≥8.1 ng/mL)分组,不同AFP分组的P53抗体、HCV基因型、ANA分布结果差异均有统计学意义(Z=-3.334、χ^(2)=77.946、Z=-7.590,P≤0.001),且98.59%(70/71)的1b型患者AFP为阳性,96.00%(24/25)的非1b型患者AFP为阴性。分别按HCV基因型与AFP分组做相应指标的相关性分析,结果发现:AFP与P53抗体、ANA呈正相关(r=0.785、0.545,P均<0.001);HCV基因型与AFP呈负相关(r=-0.512,P<0.001),即当HCV基因型由1b型转换为非1b型时,AFP检测值将降低。肿瘤大小>3 cm的HCV-HCC患者HCV 1b型、AFP阳性率明显高于≤3 cm的患者(HCV 1b型:82.00%vs. 57.14%;AFP:78.00%vs. 14.29%;χ^(2)=6.278、33.473,P均<0.05);发生肝外转移的HCV-HCC患者AFP阳性率明显高于未发生转移患者(76.32%vs. 21.57%;χ^(2)=26.376,P<0.001)。晚期(Ⅲ+Ⅳ期)HCV-HCC患者P53抗体及ANA的阳性率明显高于早期(Ⅰ+Ⅱ期)患者(P53抗体:91.38%vs. 61.76%;ANA:63.79%vs. 23.53%;χ^(2)=11.945、13.906,P均≤0.001);中低分化的HCV-HCC患者P53抗体及ANA的阳性率明显高于高分化患者(P53抗体:82.86%vs. 52.50%;ANA:62.86%vs.35.00%;χ^(2)=7.741、5.804,P均<0.05)。结论 AFP检测水平与HCV基因型有关,P53抗体及ANA的阳性率与提示HCV-HCC预后不良的临床Objective To investigate the hepatitis C virus(HCV)genotyping,the correlation between alpha-fetoprotein(AFP) and P53 antibody,antinuclear antibody(ANA) and clinicopathological analysis in patients with HCV-related hepatocellular carcinoma(HCV-HCC). Methods A total of 100 HCV-HCC patients diagnosed in the Third Hospital of Mianyang from January 2016 to June 2020 were selected. PCR-reverse dot hybridization,ELISA,electrochemiluminescence,and indirect immunofluorescence(ⅡF)were used to detect HCV genotyping,P53 antibody,AFP,and ANA. Compared the differences in the distribution of HCV genotypes,P53 antibodies,and ANA distribution results in different AFP groups,analyzed the correlation between HCV genotypes,AFP and P53 antibodies,and ANA;compared HCV genotypes,AFP,P53 antibodies,and ANA positive rate in different HCV-HCC pathological. Results The distribution results of P53 antibody,AFP and ANA distribution results in patients with type HCV 1b HCV-HCC were significantly higher than those of patients with non-1 b(Z=-3.741,-6.846,-5.042,all P<0.001). According to AFP negative(AFP<8.1 ng/mL)and AFP positive(AFP≥8.1 ng/mL),the differences in P53 antibody,HCV genotype,and ANA distribution results of different AFP groups were statistically significant(Z=-3.334,χ^(2)=77.946,Z=-7.313,P≤0.001),and 98.59%(70/71)of type 1b patients were AFP positive,and 96.00%(24/25) of non-1 b patients were AFP negative. Correlation analysis of corresponding indicators was done according to HCV genotype and AFP grouping,and the results showed that:AFP was positively correlated with P53 antibody and ANA(r=0.785,0.545,P<0.001);HCV genotype was negatively correlated with AFP(r=-0.512,P<0.001),which means that when the HCV genotype changes from 1b to non-1 b,the AFP detection value will decrease accordingly. The positive rate of HCV 1b and AFP in HCV-HCC patients with tumor size >3 cm is significantly higher than that of patients with ≤3 cm(HCV 1b:82.00% vs. 57.14%;AFP:78.00% vs. 14.29%;χ^(2)=6.278,33.473,P<0.05);the positive rate of AFP

关 键 词：丙型肝炎病毒 基因型 甲胎蛋白 自身抗体 肝细胞癌 

分 类 号：R735.7[医药卫生—肿瘤]