目的探讨乙型肝炎病毒血清学标志物(HBV—M)表达模式、HBV—DNA复制水平与原发性肝癌(HCC)的关系。方法216例原发性肝癌(HCC组),353例慢性乙型肝炎(CHB组),应用酶联免疫吸附试验和聚合酶链式反应方法分别检测两组血清HBV—M和HBV—DNA水平。结果两组HBV—M表达模式构成差异有统计学意义(P〉0.05),HCC组血清学小三阳(HBsAg、HBeAb、HBcAb阳性)表达率(62.04%)显著高于大三阳(HBsAg、HBeAg、HBcAb阳性)表达率(18.98%);CHB组小三阳表达率为61.47%,大三阳为36.83%;CHB组大三阳表达率高于HCC组(P〈0.05)。HBV.DNA阳性率HCC组为56.5%,CHB组为79.0%,差异无统计学意义(P〉0.05),但在HBV—DNA阳性患者中,HCC组HBV—DNA复制水平显著低于CHB组,差异有统计学意义(P〈0.05)。结论HCC患者HBV—M表达模式以小三阳为主,其HBV—DNA复制水平较CHB患者低。
Objective To explore the relationship between the development of hepatocellular carcinoma and the expression model of hepatitis B virus serological markers (HBV-M) or the replication level of hepatitis B virus DNA (HBV-DNA). Methods 216 cases of hepatocellular carcinoma were enrolled as case group (HCC group), and 353 patients with chronic HBV infection as the control group( CHB group), Enzyme-linked immunosorbent assay(ELISA) and polymerase chain reactiongroup (PCR)were used to detect the HBV-M and the replication level of HBV-DNA respectively. Results The rate of the model ( HBsAg, HBeAb, HBcAb positive, STP) was 62.04% and 61.47% in the case group and the control group respectively ( P 〉 0.05 ), while the rate of the model ( HBsAg, HBeAg, HBcAb positive, LTP)was 18.98% and 36.83 % in the case group and the control group respectively (P 〉 0.05 ). The rate of the model STP was significantly higher than the rate of the model LTP in the case group ( P 〉 0.05 ), but there was no significant difference in the control group. The rate of the model LTP in CHB group was also higher than that in HCC group(P 〈0.05 ). Positive rates of HBV-DNA in the patients with HCC and the patients with chronic HBV infection were 56.5% and 79% respectively. The replication level of HBV-DNA in HCC group(4.99 ± 1.02)was significantly lower than that (5.80 ± 1.43 ) of CHB group ( P 〈 0.05 ). Conclusion The expression model of HBsAg, HBeAb, HBcAb in patients with hepatocellular carcinoma is given priority to the patients with chronic HBV-infection, and the replication level of HBV-DNA of hepatocellular carcinoma is significantly lower than that of chronic HBV infection.