肝硬化及肝癌患者HBV-M模式差异性

The discrepancy of HBV-M models in patients with liver cirrohsis and hepatocellular carcinoma

目的探讨乙型肝炎病毒标志物(HBV-M)在肝硬化(LC)和肝细胞癌(HCC)中表现模式的差异及其临床意义。方法HBV-M五项中至少有一项阳性的LC患者68例,HCC患者64例,对2组间HBV-M的表现模式进行比较分析。结果LC和HCC间HBV-M表现模式有明显差异,HCC中HBeAg阳性模式明显高于LC患者,2组分别为46.0%和23.9%(P<0.01),LC患者中则以HBeAg阴性的“小三阳”(B)和“二阳”(C)占多数,分别为34.3%和41.8%,而B、C模式在HCC患者中分别为20.6%和31.7%。结论HCC中HBeAg阳性的HBV-M模式明显高于LC患者;对于HBV感染者,尤其是HBeAg阳性的患者要警惕发生HCC的可能。

Objective To explore the discrepancy of HBV - M models and their clinical significance in patients with liver cirrohsis （LC） and hepatocellular carcinoma （HCC）. Methods In 68 HB patients with LC and 64 with HCC, in whom at least one of the five HBV - Ms was positive, the HBV - M models were compared between the two groups. Results The HBV - Ms appeared in four models： model A, HBsAg ＋ , HBeAg ＋ , anti - HBc ＋ ; model B, HBsAg ＋ , anti - HBe ＋ , anti - HBc ＋ ; model C, HBsAg ＋ , anti - HBc ＋ ; model D, others. The rate of HBeAg positivity was much higher in HCC group than in LC group （46.0 % vs. 23.9 %, P 〈 0.01 ）. In LC group, the rates of model B and model C were 40.1% and 49.2 % respectively, while in HCC group, they were 21.7 % and 31.7 %. Conclusion The rate of HBeAg positivity in HCC patients is much higher than in LC patients. In patients with HBV infection, especially the HBeAg positive ones, it is important to be on guard against the genesis of HCC.