HBV、HCV、HBV和HCV重叠感染与HCC发生关系的研究

AN INVESTIGATION IN THE RELATIONSHIP BETWEEN THE SUPERINFECTION OF HBV,HCV AND THE OCCURRENCE OF HEPATOCELLULAR CARCINOMA

目的:探讨HBV、HCV、HBV和HCV重叠感染及复制与广西HCC发生的关系。方法:在肝癌高发区和低发区分别选择符合全国诊断标准的HCC病人78例作为病例A组(肝癌高发区组)、B组(肝癌低发区组),并分别选择相同乡镇、生活习惯、生活水平、年龄士5岁、同性别的原籍健康人群2组分别78人作为对照组C组(肝癌高发区正常人组)和D组(肝癌低发区正常人组),应用PCR法检测研究对象血清中的HBVDNA、HCVRNA,并对阳性率进行比较。结果:HBVDNA、HCVRNA、HBVDNA+HCVRNA阳性率分别为:A组6 9.2%(5 4/7 8)、2 0.5%(1 6/7 8)、1 6.7%(1 3/7 8);B组5 2.6%(4 1/7 8)、6.4%(5/78)、5.1%(4/78);C组18.0%(14/78)、7.7%(6/78)、3.8%(3/78);D组10.3%(8/78)、2.6%(2/78)、1.3%(1/78);其中A组与C组,A组与B组组间的阳性率比较差异均有统计学意义(均P<0.05),B组与D组中HBVDNA阳性率比较差异也有统计学意义(均P<0.01)。结论:HBV、HCV、HBV和HCV的重叠感染及复制与广西肝癌高发区的肝癌发生有密切关系,其中HBV的感染及复制在肝癌的发生中最为重要,高发区中HCV、HBV和HCV的重叠感染的致癌作用也是不容忽视的。

Objective.To make clear the relationship between superinfection of HBV, HCV and the occurrence of hepatocellular carcinoma in Guangxi, China. Methods：78 hepatocellular carcinoma cases were selected as the case group A and 13 from the areas with high and low morbidity of HCC respectively; 78 healthy persons were selected as the control group C and D from the same area as above respectively, with matching the case and control group according to their sex, age of 5-year differences, living conditions, customs etc. The serological H13VDNA, HCVRNA from the subjects were tested by quantity PCR. Result： The positive rates of H13VDNA, HCVRNA, H13VDNA＋ HCVRNA in the group A, 13, C and D were 69.2%（54/78）, 20.5%（16/78）, 16.7%（13/78）; 52.6%（41/78）, 6.4%（5/78）, 5.1%（4/78）; 18.0% （14/78）, 7.7%（6/78）, 3.8（3/78）; 10.3%（8/78）, 2.6%（2/78）, 1.3%（1/78） respectively. There was very significant difference between Group A and C, Group A and B in the positive rates of all above （ P 〈0. 05）. There was also obviously significant difference between Group B and D in the positive rate of HBVDNA. Conclusion：The infection of HBV and HCV and HBV/HCV superinfection, as well as the replication of HBV and HCV might play an important role in the occurrence of HCC in endemic area of HCC in Guangxi, China. In these, the infection and the replication of HBV play a most important role. The carcinogenesis of HBV infection and HBV/HCV superinfection shall be closely observed.