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Correlation between drug-resistance gene mutations and hepatocellular carcinoma in patients with hepatitis B virus infection
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摘要:
目的探讨HBV耐药基因突变与肝细胞癌（HCC）的相关性。方法收集2013年1月1日-12月31日在北京地坛医院进行HBV耐药基因突变检测,且为核苷和核苷酸类药物经治,但HBV DNA仍可检测到的患者的临床资料。对其进行随访,以出现HCC为临床结局。分析HBV感染者耐药基因突变与HCC发生的相关性。计数资料组间比较采用χ2检验,计量资料组间比较采用t检验,并采用log-rank检验比较组间HCC发生率的差异。结果共有227例患者纳入研究,其中HBV耐药基因突变检测结果中未检测到耐药基因突变者占45.37%（103/227）,检测到耐药基因突变者占54.63%（124/227）。HBV耐药基因突变组与未突变组的HBV DNA载量分别为（5.19±1.60）log10IU/ml、（5.44±1.75）log10IU/ml,两组差异无统计学意义（t=-1.134,P=0.258）。HBV耐药基因突变组与未突变组中肝硬化患者的比例分别为24.19%（30/124）、16.50%（17/103）,两组差异亦无统计学意义（χ2=2.026,P=0.155）...
Abstract:Objective To investigate the correlation between hepatitis B virus( HBV) drug- resistance gene mutations and hepatocellular carcinoma( HCC). Methods The clinical data of treatment- experienced patients,who underwent examination for HBV drug- resistance gene mutations in Beijing Ditan Hospital from January 1 to December 31,2013,and still had detectable HBV DNA after being treated with nucleos( t) ide analogues,were collected. All the patients were followed up,and the development of HCC was considered as the clinical outcome. The correlation between drug- resistance gene mutations and the development of HCC in patients with HBV infection was analyzed.The chi- square test was used for comparison of categorical between groups,the t- test was used for comparison of continuous data between two groups,and the log- rank test was used for comparison of the incidence of HCC between two groups. Results A total of 227 patients were enrolled in this study. According to the results of the detection of HBV drug- resistance gene mutations,103 patients( 103 /227,45. 37%) had no drug- resistance gene mutations and 124( 124 /227,54. 63%) had drug- resistance gene mutations. There were no significant differences between the mutation group and the non- mutation group in HBV DNA load( 5. 19 ± 1. 60 log10 IU / ml vs 5. 44 ± 1. 75log10 IU / ml,t =- 1. 134,P = 0. 258) and the percentage of patients with liver cirrhosis( 24. 19%( 30 /124) vs 16. 50%( 17 /103),χ~2=2. 026,P = 0. 155). The median follow- up was 28 months( range 4- 58 months),and the incidence of HCC was 7. 49%( 17 /227). Among the patients with HBV drug- resistance gene mutations,12( 12 /124,9. 68%) developed HCC,and among those without HBV drug- resistance gene mutations,5( 5 /103,4. 85%) developed HCC. Among the patients who developed HCC,70. 59%( 12 /17) had HBV drug- resistance gene mutations at baseline; among the patients who did not develop HCC,53. 33%( 112 /210) had HBV drug- resistance gene mutations at baseline. Conclusion The patients with poor control of HBV DNA during antiviral therapy have a comparable incidence of HCC to those not treated with antiviral therapy,with a relatively high risk of developing HCC; the treated patients with HBV drug- resistance gene mutations may have a higher risk of HCC than those without such mutations,which needs to be confirmed by the studies with a longer follow- up period and a larger sample size.
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Key words:
- hepatitis B virus /
- carcinoma /
- hepatocellular /
- mutation
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