Clinical observation of the relation between the HBeAg and HBV-related hepatocellular carcinoma
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摘要: 目的研究HBeAg阴性与HBeAg阳性的乙型肝炎相关性原发性肝癌患者生化指标和病毒相关因素的差异,并探讨其临床意义。方法回顾性分析华西第一附属医院2009年1月~2010年11月以来住院的合并HBV感染原发性肝癌患者220例,分为HBeAg阳性与HBeAg阴性两组。探讨两组甲胎蛋白(AFP)水平、肝功能水平,HBV DNA定量、肝组织学指标的差异。结果HBeAg阳性原发性肝癌195例,占总数的89%;HBeAg阴性原发性肝癌25例,占总数的11%;HBeAg阳性组HBVDNA定量对数均值显著高于HBeAg阴性组(t=2.01,P<0.05);HBeAg阴性组肝纤维化分期为4期的比例为40%,明显高于HBeAg阳性组21%(χ2=9.5,P=0.049)。两组在AFP,肝功能等指标上差异无统计学意义。结论 HBeAg阳性原发性肝癌发生率高于阴性者。同HBeAg阳性原发性肝癌相比,HBeAg阴性肝癌患者肝组织学损害程度较重,合并肝硬化更为常见,预后更差。HBeAg阴性患者并发肝细胞癌,早期漏诊率高于阳性者。Abstract: Objective To study the virus-related factors, biochemical differences in the HBeAg-negative and HBeAg-positive patients with primary liver cancer, and to explore the clinical significance.Methods Retrospective analysis of merger of 220 cases of hospitalized HBV infection with primary liver cancer in the First Affiliated Hospital of West China from January 2009 to November 2010, and were divided into HBeAg-positive and HBeAg-negative groups.Analysis of AFP level, liver function levels, HBV DNA quantitative, targets liver histology differences of the two groups were made.Results 195 cases of HBeAg-negative primary liver cancer accounting for 89%;25 cases of HBeAg-positive hepatocellular carcinoma, accounting for 11%.HBeAg-positive group HBV DNA quantitative was significantly higher than the mean of the number of HBeAg negative group (t= 2.01, P<0.05) ;HBeAg-positive group stage four liver fibrosis ratio of 32%, was significantly higher than the HBeAg negative group of 21% (χ2= 9.5, P= 0.049) .The AFP level and other indicators of liver function of the two groups had no statistically significant difference.Conclusion The incidence of HBeAg-positive HCC was higher than that of HBeAg-negative, which was inconsistent with the domestic Zou Chuanxin report.Compared with HBeAg-negative primary liver cancer, liver damage in HBeAg-positive patients was commonly observed with severe liver histology, combined with portal cancer, and cirrhosis of the liver and making the prognosis even worse.HBeAg-negative patients with hepatocellular carcinoma was higher than the HBeAg-positive.
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Key words:
- hepatitis B /
- chronic /
- hepatitis B e antigens /
- carcinoma
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