HBV相关性HCC的临床特征分析

Analysis of clinical characters of HBV related HCC

目的探讨HBV相关性HCC的临床特征。方法收集HBV相关性HCC患者50例资料,检测患者血清HBV M定量、HBV DNA定量、肝纤维化指标、AFP、肝功能指标。用彩色超声、64层螺旋CT、1.5T核磁共振检查患者肝脏影像学情况。用相应的统计学方法对上述指标进行分析。结果 HBV相关性HCC好发于40~60岁男性,72%的患者有乙肝家族史,74%的患者AFP升高,92%的患者肿块发生在肝右叶。HBsAg、HBeAb、HBcAb大于ULN是HBV相关性HCC主要的HBV M模式（80%）,这种模式的患者多伴HBV DNA复制（χ2=38.093,P〈0.001）,且HBeAb定量与HBV DNA定量呈正相关（r=0.374,P=0.018）。结论 HBV相关性HCC多发于40~60岁男性,多伴乙肝家族史,且并非所有患者都伴AFP升高,在监测中要高度重视HBsAg、HBeAb、HBcAb大于ULN且有HBVDNA复制的患者,特别注意肝右叶的表现,必要时可缩短其监测周期。

Objective To analyze clinical characters of HBV related HCC.Methods 50 patients with HBV related HCC were recruited.The serological indexes including quantity of HBV M,HBV DNA,AFP,HA and ALT were measured.The imaging tests including B ultrasound,CT and MRI were measured.Results The male patients were 88%.The average age was 40-60 year old.72% cases with the hepatitis B infection most likely acquired at birth or in early childhood.AFP of 74% patients was more than the upper limited normal.92% of the tumor were in the right lobe of liver.HBsAg,HBeAb and HBcAb positive mode（80%） was the most common mode in HBV related HCC.Statistical analysis showed that HBeAb was positive correlation with HBV DNA（r=0.374,P=0.018）.Conclusion The tumor were more likely occurred in male cases who were 40-60 year-old,and always with the hepatitis B infection most likely acquired at birth or in early childhood,not all the cases with high AFP,the mode of HBsAg,HBeAb,HBcAb positive cases always with HBV DNA replication.