弥漫大B细胞淋巴瘤与乙型肝炎病毒感染相关性分析

Correlation between diffuse large B-cell lymphoma and hepatitis B virus infection

目的探讨乙型肝炎病毒(hepatitis B virus,HBV)感染状态与弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)发病的相关性。方法收集2012年9月-2018年9月于徐州医科大学附属医院住院治疗的DLBCL患者388例,同期住院的滤泡性淋巴瘤(follicular lymphoma,FL)患者53例,T/NK细胞淋巴瘤患者172例,非淋巴细胞恶性肿瘤患者363例(肺癌185例和乳腺癌178例)。所有患者均为初次住院治疗,诊断经病理活检证实。另随机抽取我院体检中心的健康人541名作为健康对照组。所有调查对象均完善HBV血清学标志5项检查。结果 388例DLBCL患者HBsAg阳性率为13.9%(54/388),53例FL患者HBsAg阳性率为13.2%(7/53),172例T/NK细胞淋巴瘤患者HBsAg阳性率为4.1%(7/172),363例非淋巴细胞恶性肿瘤患者HBsAg阳性率为5.8%(21/363),541例健康体检人员的HBsAg阳性率为3.3%(18/541)。DLBCL组与FL组HBsAg阳性率差异无统计学意义(P> 0.05),但明显高于T/NK细胞淋巴瘤组、非淋巴细胞恶性肿瘤组、健康体检组(P均<0.05)。FL组HBV慢性感染人数所占比例明显高于T/NK细胞淋巴瘤组、非淋巴细胞恶性肿瘤组、健康体检组患者(P均<0.05)。结论 DLBCL和FL患者的HBV感染率高于T细胞淋巴瘤、非淋巴细胞性恶性肿瘤患者和健康体检者。DLBCL患者与FL患者HBsAg阳性率无显著差异,HBV感染与DLBCL、FL发病之间存在相关性。

Objective To investigate the relationship between infection status of hepatitis B virus(HBV)and the occurrence of diffuse large B-cell lymphoma(DLBCL).Methods A total of 388 patients with DLBCL who were treated in the Affiliated Hospital of Xuzhou Medical University from September 2012 to September 2018,and 53 patients with follicular lymphoma(FL),172 patients with T/NK cell lymphoma and 363 cases with non-lymphocytic malignancy(185 cases of lung cancer and 178 cases of breast cancer)treated in the same period were included.All patients were hospitalized for the first time and the diagnosis was pathologically confirmed.Another 541 healthy people from the health examination center were selected as the control group.All subjects had completed Hepatitis B serologic test.Results The positive rate of HBsAg in 388 patients with DLBCL was 13.9%(54/388),it was 13.2%(7/53)in patients with FL,4.1%(7/172)in patients with T/NK cell lymphoma,5.8%(21/363)in patients with non-lymphocytic malignancies,and 3.3%(18/541)in 541 healthy subjects.There was no significant difference in the positive rate of HBsAg between patients with DLBCL and patients with FL(P>0.05),but both of them were significantly higher than positive rate in T/NK cell lymphoma group,non-lymphocytic malignancy group,and healthy physical examination people(all P<0.05).The proportion of chronic HBV infection in the FL group was significantly higher than that in the T/NK cell lymphoma group,the non-lymphocytic malignant tumor group,and the healthy physical examination group(all P<0.05).Conclusion The prevalence of HBV infection in patients with DLBCL and FL is higher than that in patients with T-cell lymphoma,non-lymphocytic malignancy and healthy subjects.There is no significant difference in HBsAg positive rate between DLBCL patients and FL patients.We believe that HBV infection has a certain correlation with the occurrence of DLBCL and FL.