非霍奇金淋巴瘤患者乙型肝炎病毒感染情况分析

Analysis of hepatitis B virus infection in patients with non-Hodgkin lymphoma

目的 分析非霍奇金淋巴瘤（NHL）患者乙型肝炎病毒（HBV）感染发生情况.方法 采用全自动微粒子化学发光免疫分析法检测2014年1月至2016年12月西南医科大学附属医院确诊的305例NHL患者血清中HBV标志物,并与同期住院的312例大肠癌患者及81775名全国普通人群HBV检出率进行比较.结果 305例NHL患者的乙型肝炎病毒表面抗原（HBsAg）阳性率、乙型肝炎病毒表面抗体（HBsAb）阳性率、乙型肝炎病毒核心抗体（HBcAb）阳性率与全国普通人群比较,差异均有统计学意义[19.0％（58/305）比7.2％（5888/81775）,44.3％（135/305）比50.1％（40969/81775）,45.9％（140/305）比34.1％（27885/81775）,χ2值分别为63.1、4.1、18.8,均P〈0.05],且NHL患者的HBsAg阳性率与大肠癌患者及全国普通人群比较,差异有统计学意义（χ2=65.7,P〈0.01）.B细胞NHL（B-NHL）和T细胞NHL（T-NHL）患者的HBsAg阳性率比较,差异有统计学意义[21.3％（51/239）比10.6％（7/66）,χ2=3.869,P〈0.05],而两组患者的HBsAb、HBcAb阳性率比较,差异无统计学意义（均P〉0.05）.133例NHL患者进行HBV DNA检测,其中44例（33.1％）阳性,58例HBsAg阳性患者中43例（74.1％）HBV DNA阳性,HBsAg阴性但HBcAb阳性的24例患者中1例（4.2％）HBV DNA阳性.结论NHL患者的HBV感染率高于大肠癌患者及全国普通人群,其中HBV的隐匿性感染是值得重视的问题.T-NHL患者的HBsAg阳性率低于B-NHL患者.如果NHL患者合并HBV感染,为预防HBV激活应在抗肿瘤治疗前给予抗病毒治疗.

Objective To investigate the association between non-Hodgkin lymphoma （NHL） and hepatitis B virus （HBV）. Methods The serum HBV markers in 305 NHL patients who were diagnosed in the Affiliated Hospital of Southwest Medical University from January 2014 to December 2016 was detected by automatic chemiluminescence immunoassay. The infection rate of HBV in NHL patients was compared with that in 312 colorectal cancer patients and the national general population （81775 peoples）. Results The positive rates of hepatitis B surface antigen （HBsAg）, hepatitis B surface antibody （HBsAb） and hepatitis B core antibody （HBcAb） in 305 patients of NHL were compared with the general population [19.0 ％ （58/305） vs. 7.2 ％ （5888/81775）, 44.3 ％ （135/305） vs. 50.1 ％ （40969/81775）, 45.9 ％ （140/305） vs. 34.1 ％（27885/81775）], and the differences were statistically significant （χ2 values were 63.1, 4.1, 18.8, all P〈0.05）. The positive rate of HBsAg in NHL patients was compared with colorectal cancer patients and the general population, and the differences were statistically significant （χ2= 65.7, P 0.05）. Among 133 NHL patients, the HBV DNA positive rate was 33.1 ％ （44/133）, and 74.1 ％ （43/58） in 58 cases of HBsAg-positive NHL, while 4.2 ％ （1/24） in 24 cases of HBsAg-negative but HBcAb-positive NHL. Conclusions The infection rate of HBV in NHL patients is higher than that in colorectal cancer patients and the general population, in which the occult HBV infection is worthy of much attention. The positive rate of HBsAg in T-cell NHL patients is lower than that in B-cell NHL patients. For NHL patients with HBV infection, anti-HBV treatment to prevent reactivation of the virus should be given before the anti-tumor treatment.