p53通路基因多态性与HBV感染相关肝细胞癌患者术后病毒激活的关联  

Relationship between polymorphisms of p53 pathway genes and postoperative virus activation in patients with HBV infection related hepatocellular carcinoma

作　　者：林海燕[1] 王丽华[2] 林红霞 王芳[3] 王辉微 LIN Hai-yan;WANG Li-hua;LIN Hong-xia;WANG Fang;WANG Hui-wei(Haikou Hospital Affiliated to Xiangya Medical College of Central South University,Haikou,Hainan 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院静脉治疗中心,海南海口570208 [2]中南大学湘雅医学院附属海口医院乳腺外科,海南海口570208 [3]中南大学湘雅医学院附属海口医院营养科,海南海口570208 [4]中南大学湘雅医学院附属海口医院肿瘤化疗科,海南海口570208

出　　处：《中华医院感染学杂志》2022年第10期1473-1477,共5页Chinese Journal of Nosocomiology

基　　金：海南省卫生计生行业科研基金资助项目(18A200062)。

摘　　要：目的 探讨p53通路基因多态性与乙型肝炎病毒(HBV)感染相关肝细胞癌(HCC)患者术后病毒激活的关系。方法 选取中南大学湘雅医学院附属海口医院2017年10月-2019年11月80例HBV相关HCC手术治疗患者,按照术后病毒再激活情况分为再激活组和未激活组,检测p53通路基因分型,探讨术后病毒激活的危险因素。结果 80例HBV相关HCC手术患者中19例出现HBV再激活,再激活率23.75%,再激活组P53基因Exon4 Arg72 pro位点Pro/Pro基因频率高于未激活组,Pro等位基因频率高于未激活组(P<0.05),多因素Logistic回归分析结果显示肿瘤≥5 cm、术前HBV DNA载量≥500拷贝/ml是HCC术后病毒激活的独立危险因素,术前抗病毒治疗是预防病毒激活的保护因素;P53基因Exon4 Arg72 pro位点Pro/Pro基因型是病毒激活的危险基因型,OR值为1.499(95%CI:1.058~2.125),再激活组术后1年肝癌累积复发率42.11%(8/19)高于未激活组18.03%(11/61)(P<0.05)。结论 P53基因Exon4 Arg72 pro位点Pro/Pro基因型是HBV相关HCC手术患者术后病毒激活危险基因型。OBJECTIVE To explore the relationship between polymorphisms of p53 pathway genes and postoperative virus activation in patients with hepatitis B virus(HBV) infection-related hepatocellular carcinoma(HCC). METHODS Totally 80 patients with HBV-related HCC who received surgical procedures in Haikou Hospital Affiliated to Xiangya Medical College of Central South University from Oct 2017 to Nov 2019 were enrolled in the study and divided into the reactivation group with the no activation group according to the status of postoperative virus reactivation. The genotypes of p53 pathway genes were detected, and the risk factors for the postoperative virus activation were explored. RESULTS Among the 80 patients with HBV-related HCC, 19 had reactivation of HBV, with the reactivation rate 23.75%. The frequency of Pro/Pro genotype at Exon4 Arg72 pro locus of P53 gene was higher in the reactivation group than in the no activation group, and the frequency of Pro allele of the reactivation group was higher than that of the no activation group(P<0.05). The result of logistic regression analysis showed that tumor no less than 5 cm and preoperative HBV DNA load no less than 500 copies/ml were independent risk factors for the postoperative virus activation in the HCC patients, and the preoperative antiviral therapy was the protective factor for the prevention of virus activation;the Pro/Pro genotype at Exon4 Arg72 pro locus of P53 gene was the risk genotype for the virus activation, with the OR value 1.499(95%CI:1.058~2.125). The cumulative recurrence rate of HCC 1 year after surgery was 42.11%(8/19) in the reactivation group, higher than 18.03%(11/61) in the no activation group(P<0.05). CONCLUSION The Pro/Pro genotype at Exon4 Arg72 pro locus of P53 gene is the risk genotype for the postoperative virus activation in the patients with HBV-related HCC.

关 键 词：肝细胞癌 乙型肝炎病毒 病毒激活 P53通路 基因多态性 关联 

分 类 号：R735.7[医药卫生—肿瘤]