92031例癌症患者HBV血清标志物特征分析

Analysis of hepatitis B virus serum markers in 92,031 cancer patients

目的了解癌症患者乙型肝炎病毒(hepatitis B virus,HBV)的感染状态和感染特点。方法回顾性分析2017年7月26日至2023年9月18日于广西医科大学附属肿瘤医院确诊的92031例癌症患者的HBV血清标志物检测结果,以肝癌、非肝癌进行分组,比较未感染(全阴或Anti-HBs阳性)、感染(除外Anti-HBs任何一项阳性)、隐性感染(occult hepatitis B virus infection,OBI;HBsAg阴性、血清或肝组织HBV DNA阳性)的占比。结果92031例癌症患者的HBV总感染率为73.75%(67876/92031),其中肝癌患者的HBV总感染率为97.65%(8922/9137),非肝癌患者的HBV总感染率为71.12%(58954/82894),肝癌组的普通感染率和OBI率均显著高于非肝癌组(均P<0.001)。肝癌组HBV血清标志物中HBsAg、HBeAg、Anti-HBe、Anti-HBc的阳性率明显高于非肝癌组(均P<0.001),但Anti-HBs的阳性率低于非肝癌组(P<0.001)。肝癌组和非肝癌组分别有20种和27种血清标志物组合模式,其中14种模式构成比在两组间差异有统计学意义(均P<0.001);两组均有7种OBI血清组合模式,其中5种模式构成比在两组间的差异有统计学意义(均P<0.05)。结论癌症患者HBV感染状态和血清学组合模式复杂,区分肝癌与非肝癌进行HBV感染统计更利于癌症患者的HBV感染评估。

Objective To investigate the status and characteristics of hepatitis B virus(HBV)infection in cancer patients.Methods The detection results of the HBV serum markers of 92,031 patients diagnosed with cancer in Guangxi Medical University Cancer Hospital from July 26,2017 to September 18,2023 were retrospectively analyzed.The patients were grouped into the liver cancer(LC)group and the non‑liver cancer(non‑LC)group,and the proportion of patients with uninfected(all negative or Anti‑HBs positive),ordinary infected(except for Anti‑HBs,any test positive)and occult hepatitis B virus infection(OBI;HBsAg negative,serum or liver tissue HBV DNA positive)were compared and analyzed statistically.Results The total HBV infection rate of 92,031 cancer patients was 73.75%(67,876/92,031),among which the total HBV infection rate of patients with liver cancer was 97.65%(8,922/9,137),and that of patients without liver cancer was 71.12%(58,954/82,894).The total HBV infection rate in the LC group was significantly higher than that in the non‑LC group(all P<0.001).The positive rates of HBsAg,HBeAg,Anti‑HBe and Anti‑HBc in the LC group were significantly higher than those in the non‑LC group(all P<0.001),whereas the positive rate of Anti‑HBs in the LC group was lower than that in the non‑LC group(P<0.001).There were 20 and 27 combination patterns of serum markers in the LC group and the non‑LC group,respectively,among which the constituent ratios of 14 patterns were significantly different between the two groups(all P<0.001).There were 7 combination patterns of OBI serum in both groups,and the constituent ratios of 5 patterns were statistically different between the two groups(all P<0.05).Conclusions HBV infection status and serological combination patterns of cancer patients are complex,and distinguishing between liver cancer and non‑liver cancer for HBV infection statistics is more conducive to the evaluation of HBV infection in cancer patients.