乙型肝炎病毒DNA、丙型肝炎病毒RNA在原发性肝癌患者中的表达及临床意义  

Expression and clinical significance of hepatitis B virus DNA and hepatitis C virus RNA in patients with primary liver cancer

作　　者：孙倩 徐雪勤 郑晶冰 SUN Qian;XU Xueqin;ZHENG Jingbing(Department of Laboratory Medicine,Zhumadian Central Hospital,Zhumadian 463000,He’nan,China)

机构地区：[1]驻马店市中心医院医学检验科,河南驻马店463000

出　　处：《癌症进展》2023年第22期2510-2515,共6页Oncology Progress

基　　金：河南省医学科技攻关计划项目(LHGJ202203027)。

摘　　要：目的 探讨乙型肝炎病毒(HBV)DNA、丙型肝炎病毒(HCV)RNA在原发性肝癌患者中的表达及临床意义。方法 选取145例原发性肝癌患者和106例肝硬化患者,分别作为原发性肝癌组和肝硬化组。比较两组患者的HBV、HCV感染率,分析原发性肝癌患者HBV感染模式及HBV DNA阳性分布情况。采用Logistic回归模型分析原发性肝癌的影响因素。随访2年,采用Cox回归模型分析原发性肝癌患者预后的影响因素。结果原发性肝癌组患者HBV、HCV感染率均高于肝硬化组,差异均有统计学意义(P﹤0.05)。原发性肝癌患者中,乙型肝炎e抗体(抗HBe)(+)乙型肝炎核心抗体(抗HBc)(+)HBV表面抗原(HBsAg)(+)感染模式占比最高(50.50%),且HBV DNA阳性患者主要分布于该模式中,其次为抗HBc(+)HBsAg(+)(16.83%)。原发性肝癌组患者HBsAg(+)、抗HBe(+)、HBV DNA(+)、HCV RNA(+)比例均高于肝硬化组,差异均有统计学意义(P﹤0.05)。多因素Logistic回归分析结果显示,HBV DNA阳性、HCV RNA阳性均是原发性肝癌的独立危险因素(P﹤0.05)。原发性肝癌患者的2年生存率为70.34%,2年无进展生存率为53.10%。无嗜酒史、肿瘤最大径≤5 cm、HBV DNA阴性、HCV RNA阴性原发性肝癌患者的2年生存率分别高于有嗜酒史、肿瘤最大径﹥5 cm、HBV DNA阳性、HCV RNA阳性患者,差异均有统计学意义(P﹤0.05)。多因素Cox回归分析结果显示,HBV DNA阳性和HCV RNA阳性均是原发性肝癌患者预后的独立危险因素(P﹤0.01)。结论 原发性肝癌患者HBV、HCV感染率均较高,HBV DNA阳性、HCV RNA阳性均是原发性肝癌患者预后的独立危险因素。Objective To investigate the expression and clinical significance of hepatitis B virus(HBV) DNA and hepatitis C virus(HCV) RNA in patients with primary liver cancer.Method A total of 145 patients with primary liver cancer were enrolled into the primary liver cancer group and 106 patients with liver cirrhosis were enrolled into the liver cirrhosis group.HBV infection rate and HCV infection rate were compared between the two groups.The pattern of HBV infection and HBV DNA positive distribution in patients with primary liver cancer were analyzed.Logistic regression model was used to analyze the influencing factors of primary liver cancer.The patients were followed up for 2 years and the Cox regression model was used to analyze the prognostic factors in patients with primary liver cancer.Result The HBV infection rate and HCV infection rate in the primary liver cancer group were significantly higher than those in the liver cirrhosis group(P<0.05).In primary liver cancer group,the proportion of hepatitis B e antibody(anti-HBe)(+) hepatitis B core antibody(anti-HBc)(+) hepatitis B surface antigen(HBsAg)(+) infection pattern was the highest(50.50%),most HBV DNA-positive patients had this infection pattern,followed by anti-HBc(+) HBsAg(+) pattern(16.83%).The proportions of HBsAg(+),anti-HBe(+),HBV DNA(+),and HCV RNA(+) in the primary liver cancer group were significantly higher than those in the liver cirrhosis group(P<0.05).Multivariate Logistic regression analysis showed that HBV DNA positive and HCV RNA positive were independent risk factors for primary liver cancer(P<0.05).The 2-year survival rate and 2-year progression-free survival rate of primary liver cancer patients were 70.34% and 53.10% respectively.The 2-year survival rates of primary liver cancer patients without alcohol history,with maximum tumor diameter≤5 cm,negative HBV DNA and negative HCV RNA were higher than those with drinking history,maximum tumor diameter>5cm,positive HBV DNA and positive HCV RNA(P<0.05).Multivariate Cox regression analysis showed

关 键 词：原发性肝癌 乙型肝炎病毒 丙型肝炎病毒 DNA RNA 

分 类 号：R735.7[医药卫生—肿瘤]