乙型肝炎病毒感染与肝细胞癌相关性的多因素研究

Multifactor study on the relationship between infection of hepatitis B virus and hepatocellular carcinoma

目的了解宿主遗传、免疫以及病毒等因素在肝细胞癌(HCC)形成中的作用,探讨乙型肝炎病毒(HBV)感染与HCC形成的多因素相关性。方法选择慢性乙型肝炎(CHB)87例、乙型肝炎肝硬化(LC)38例和HCC 34例,分别对其进行HLA-DR基因型、血清IFN-γ和TNF-α水平、HBV基因型及其前C区1896位和BCP区1762/1764位基因变异情况的检测。结果单因素分析发现,HCC组和LC组的HLA-DR13基因频率、血清TNF-α水平、HBV前C区1896位和BCP区1762/1764位基因变异率均高于CHB组,有显著性差异(P<0.05)。而血清IFN-γ水平和HBV基因型在CHB组、LC组和HCC组间无显著性差异(P>0.05)。Logistic回归分析结果显示,血清TNF-α水平升高和HBV前C区G1896A变异是HCC和LC的危险因素。结论血清TNF-α水平升高和HBV前C区G1896A变异是HBV相关HCC形成的危险因素,可能在HCC形成中具有重要意义。

Objective To find out the roles of factors such as host hereditary,immunity and virus etc.in the formation of hepatocellular carcinoma(HCC),and to investigate the relationship between infection of Hepatitis B virus and multifactors of hepatocarcinogenesis.Methods The HLA-DR genotypes,levels of IFN-γ and TNF-α in sera,genotypes of HBV and the mutations at nucleotides 1896 of pre-C and 1762/1764 of basic core promoter were determined from sera of 87 cases of patients with chronic hepatitis B(CHB),38 patients with liver cirrhosis(LC)and 34 cases of patients with HCC.Results Univariate analysis revealed that the gene frequencies of HLA-DR13,levels of TNF-α in sera,and the mutation rates of pre-C 1896 and basic core promoter 1762/1764 in HCC group and LC group were significantly higher than that of CHB group(P<0.05),while there was no significant difference in levels of IFN-γ and HBV genotypes among CHB group,LC group and HCC group(P>0.05).Logistic regression analysis identified that the levels of TNF-α in sera and the mutation of HBV pre-C G1896A were risk factors of HCC and LC.Conclusions The levels of TNF-α in sera,and the mutation of HBV pre-C G1896A are risk factors of the pathogenesis of HBV related HCC,might play important roles in the formation of HCC.