原发性肝癌患者病毒标志物检测及介入治疗对HBV DNA的影响

DETECTION OF SERUM HBV MARKERS IN PATIENTS WITH HCC AND THE EFFECT OF TACE THERAPY ON HBV DNA LEVELS

目的研究乙型肝炎病毒DNA和血清标志物与原发性肝癌的关系以及介入治疗前后HBV DNA和肝功能的变化。方法对151例肝癌患者做HBV-m,HBV DNA和AFP测定,对14例肝癌病人介入前后测HBV DNA和肝功能。结果肝癌患者HBV总感染率为96.68%,以HBsAg、抗HBe、抗HBc3c项同时阳性模式(俗称小三阳)最多见,占53.64%(81/151),其次为HBsAg、HBeAg、抗HBc 3项同时阳性(俗称大三阳)占20.52%(31/151)。小三阳中HBV DNA阳性占74.07%(60/81);AFP阳性率63.6%(91/143),介入治疗引起肝功能损害加重,HBV DNA水平升高,前者有显著性差异,后者无显著性差异。结论HBV感染与肝癌发生密切相关,而且以HBsAg、抗HBe、抗HBc 3项同时阳性模式最多见,该模式中大部分患者HBV DNA处于复制活跃状态;介入治疗引起肝功能损害加重,对HBV DNA水平的影响应引起重视。

Objective To investigate hepatitis B virus（HBV） markers in the sera of patients with hepatocellular carcinoma（HCC） and the alteration of liver function and HBV DNA levels before and after interventional therapy. Methods To detect HBV markers, HBV DNA and AFP in 151 patients with HCC and study HBV DNA levels and liver function in 14 patients with HCC before and after interventional therapy. Results Of the 151 HCC patients, the total HBV infection rate was 96, 68 %. The infection mode of HBV serum markers in HCC patients was mostly HBsAg, anti -HBe, and anti-HBc positive mode, which was 53.64%. In this mode, HBV DNA positive rate was 74.07%, and 91 cases were AFP positive among 143 HCC, about 63.6%, Transhepatie arterial infusion chemotherapy（TACE） caused the damage of liver function and elevation of HBV DNA levels. The former was significantly different but the latter was not. Conclusions The result suggests that HBV infection was closely associated with HCC and the patients were commonly positive in all the HBsAg, anti-HBe, and anti-HBc tests. HBV replication was still active in rome patients with HCC. The liver function of patients with HCC became worse after interventional therapy. We should pay more attention to the elevation of HBV DNA levels.