HBV基本核心启动子区和前C区变异与HBeAg阴性患者肝癌发生的关系

Relationship between HBV base core promoter and precore mutation with hepatocellular carcinoma in HBeAg negative patients

目的探讨HBV基本核心启动子区(BCP)和前C区(PreC)变异与HBeAg阴性患者肝癌发生的关系。方法 204例HBeAg阴性患者分为A组(肝硬化肝癌,102例)、B组(非肝硬化肝癌,36例)和C组(慢性乙型肝炎,66例)。检测三组患者的HBV基因型及HBV BCP和PreC变异情况,分析HBV BCP和PreC变异与肝癌发生的关系。结果 A组中,HBV基因B型87例,C型14例,D型1例;B组中,HBV基因B型31例,C型5例;C组中,HBV基因B型54例,C型11例,D型1例。B组的A1896变异率高于C组(P<0.01)。单因素和多因素分析发现,A1896变异是非肝硬化肝癌发生的危险因素(P<0.01)。结论在HBeAg阴性患者中,A1896变异是非肝硬化肝癌发生的危险因素,对于肝癌的筛查有重要价值。

Objective To investigate the relationship between the HBV base core promoter（BCP）and precore（PreC）mutation with hepatocellular carcinoma in HBeAg negative patients.Methods A total of 204 patients with HBeAg negative was divided into three groups of A（cirrhotic hepatocellular carcinoma,102cases）,B（noncirrhotic hepatocellular carcinoma,36cases）and C（chronic hepatitis B,66cases）.The HBV genotypes and the mutations of HBV BCP and PreC were examined.The relationship between the HBV BCP and PreC mutation with hepatocellular carcinoma was analyzed.Results In group A,87 cases were genotype B,14 cases were genotype C,1case was genotype D.In group B,31 cases were genotype B,5cases were genotype C.In group C,54 cases were genotype B,11 cases were genotype C,1case was genotype D.The mutation rate of A1896 was higher in group B than that in group C（P〈0.01）.The univariate and multivariate analysis showed that A1896 mutation was a risk factor for noncirrhotic hepatocellular carcinoma（P〈0.01）.Conclusion A1896 mutation is a risk factor for noncirrhotic hepatocellular carcinoma in HBeAg negative patients,which is an important indicator for screening hepatocellular carcinoma.