感染乙型肝炎病毒肝癌患者体内病毒活动状态及对外科治疗的反应

Hepatitis B virus replication status and its response to surgery for tumor in hepatocellular carcinoma patients with positive markers of HBV

目的了解乙型肝炎病毒标志物阳性肝癌患者体内乙肝病毒的活动状态及外科治疗肝癌对其的影响。方法ＨＢＶＤＮＡ定性ＰＣＲ及免疫学方法检测９７例肝癌患者的血清乙肝病毒ＤＮＡ及其标志物，９７例患者分为２组，术前组６６例，术后组３１例；ＨＢＶＤＮＡ定量ＰＣＲ方法对２０例乙肝病毒阳性肝癌患者外科治疗前后血清中病毒的存在状态及血清中病毒ＤＮＡ复制数进行对比研究。结果术前组及术后组均有部分肝癌患者血清中可以发现复制型乙肝病毒，两组阳性率分别为４０９％、６４５２％，术后组较术前组有显著意义的升高（Ｐ＜００５）；２０例乙肝病毒阳性患者经外科治疗后血清中乙肝病毒ＤＮＡ复制数较术前有显著意义增加（Ｐ＜００１）。结论部分乙肝病毒阳性肝癌患者体内乙肝病毒仍然活跃复制；外科干预更加激发乙肝病毒的复制过程。

Objective To investigate the status of hepatitis B virus (HBV) activity in patients with hepatocellular carcinoma (HCC) and its response to surgical interventions for tumor in HBV positive HCC patients. Method We analyzed HBV marker results and detected HBV DNA in sera of 97 HCC patients (pre operation 66 cases,post operation 31 cases) with polymerase chain reaction (PCR) assay. We also investigated the HBV DNA titer in sera before and one week after operation in 20 HCC patients with positive HBV markers by quantitative polymerase chain reaction (Q PCR). Result HBV DNA positive rate in sera was 40 9% and 64 52% in the two subgroup respectively ( P <0 05). HBV DNA titer in sera increased after operation ( P <0 01). Conclusion The infection rate of HBV in Chinese HCC patients is very high. The replication of hepatitis B virus is strong in partial HBV marker positive HCC patients and surgical interventions may promot the virus replication.