乙型肝炎病毒基因亚型与肝细胞癌临床病理的关系

Association between Clinicopathological Characteristics of Hepatocellular Carcinoma and Hepatitis B Virus Subgenotype

【目的】探讨乙型肝炎病毒(HBV)基因亚型与肝细胞癌(HCC)临床病理学的相关性。【方法】采用多重PCR对89例已行手术治疗的伴HBV感染肝细胞癌患者进行HBV基因亚型分型,并比较不同基因亚型患者临床及病理学特征。【结果】89例肝细胞癌患者中,感染C1亚型HBV者49例(55.06%),感染B2亚型者35例(39.33%),感染C2亚型者5例(5.61%)。B2亚型患者术前甲胎蛋白(AFP)和血清谷草转氨酶(AST)平均水平、子灶形成和包膜不完整的发生率、血管侵犯比例均高于C1亚型患者(P=0.002,P=0.007,P=0.046,P=0.029,P=0.044)。但C1亚型患者肝组织纤维化分期高于B2亚型患者(P=0.022)。【结论】感染B2亚型HBV的HCC患者肿瘤侵袭性较强,复发风险较高,C1亚型者肝纤维化较重。

【Objective】 To investigate the association between hepatitis B virus （HBV） subgenotype and clinicopathological characteristics of hepatocellular carcinoma （HCC）. 【Methods】 The HBV subgenotype of 89 post-operative HCC patients with HBV infection were determined by multiplex PCR assay,then the clinical and pathological features of different subgenotype patients were compared. 【Results】 Among 89 HCC patients,49 （55.06%） were infected with HBV C1,and 35 （39.33%） were HBV B2,5（5.61%） were HBV C2. The preoperative level of alpha-fetoprotein （AFP） and asparate transaminase （AST）,the incidence of satellite nodule formation and incomplete tumor capsule as well as the proportion of vascular invasion were higher in the patients with subgenotype B2 than those in the patients with subgenotype C1 （P = 0.002,P = 0.007,P = 0.046,P = 0.029,P = 0.044）. However,subgenotype C1 patients had higher stage of liver fibrosis （P = 0.022）. 【Conclusion】 Patients infected with subgenotype B2 could be prone to more invasive behavior of HCC with higher risk of recurrence,while patients infected with subgenotype C1 may develop heavier liver fibrosis.