Systematic evaluation of HBV BCP/PC mutations on the risk of hepatocarcinogenesis

Objective:To evaluate of the effects of mutations in BCP-A1762T/G1764A and PC-G1896A genes on hepatocarcinogenesis.Methods:Computer searches for PubMed,SCI,CNKI,VIP and WanFang Data databases were conducted to collect literature on the role of mutations in the disease process associated with HBV infection from database creation to July 1,2021.Two researchers independently screened the articles,extracted information and evaluated the quality of the studies.Review Manager software version 5.4 was used for Meta-analysis.Results:A total of 40 articles were included,with a total of 12423 cases and 3710 cases of hepatocellular carcinoma.Meta-analysis showed that mutations in BCP-A1762T/G1764A gene were associated with the disease process of HBV infection and promoted hepatocellular carcinogenesis.mutations in BCP/PC gene were significant in the process of HBV infection in BCP-A1762T/G1764A in HCC vs non-HCC[OR=4.05,95%CI=2.64~6.22],CHBC[OR=3.90,95%CI=2.13~7.17],CHB[OR=2.77,95%CI=1.78~4.32],LC[OR=1.64,95%CI=0.95~2.84],which were statistically significant;in PC-G1896A mutation HCC vs non-HCC[OR=1.49,95%CI=1.02~2.17],CHBC[OR=1.56,95%CI=0.89~2.72],CHB[OR=1.80,95%CI=1.17~2.77]were statistically significant,while the difference was not statistically significant when comparing HCC with LC(P=0.4).The BCP-A1762T/G1764A mutation in the B genotypes/genotyped versus the C genotype[OR=0.36,95%CI=0.20~0.64],with a statistically significant difference,and no statistically significant difference in the PC-G1896A mutation.BCP-A1762T/G1764A mutation in the C gene in HCC versus non-HCC[OR=3.71,95%CI=1.82~7.61]and PC-G1896A mutation in HCC vs non-HCC[OR=2.81,95%CI=1.34~5.91],the differences were statistically significant.Conclusions:Current evidence suggests that mutations in the BCP-A1762T/G1764A and PC-G1896A genes have a significant effect on the increased risk of hepatocellular carcinoma and are genotype dependent.However,due to the limitation of the number and quality of included studies,these findings need to be validated by more high-quality studies.

慢性HBV感染肝纤维化风险预测列线图模型的建立与验证

目的:建立评估慢性乙型肝炎病毒(HBV)感染发生显著纤维化的可视化、定量化预测模型,并建立列线图进行验证效能。方法:选取2019年1月~2021年12月在海南医学院第一附属医院感染科住院并行肝活检穿刺术的慢性HBV感染患者180例,随机分为建模组131例和验证组49例,建模组患者分为显著纤维化组和非显著纤维化组,收集患者一般资料、血清学检测结果、肝弹性成像及肝组织检查结果,并建立慢性HBV感染显著纤维化风险预测列线图模型。结果:本研究共纳入180例慢性HBV感染患者,其中发生显著纤维化者113例(62.8%),建模组患者中有84例(64.1%)发生显著纤维化。在建模组中,比较显著纤维化和非显著纤维化患者的HBV DNA、PLT、ALT、AST、ALP、ALB、PAB、IL-6、HA、PⅢP、CIV、L.N、LSM,结果显示差异具有统计学意义(P<0.05)。显著纤维化建模组和验证组的Hosmer-Lemeshoe拟合优度检验(H-L拟合优度检验)的χ^(2)值分别为4.988和0.527,对应的P值为0.08和0.77,表示所建立的列线图模型有较好的预测精准能力;列线图预测建模组和验证组的HBV感染后发生显著纤维化的AUROC分别为0.843[95%CI(0.775~0.910)]和0.776[95%CI(0.714~0.838)],结果提示模型具有良好区分度。结论:经过逐步向后回归分析后确立ALB、HA、PⅢP、LSM、IL-6与HBV感染后发生显著纤维化更为密切相关,综合评估建立可视化发生显著纤维化列线图模型,并给予验证均优于传统模型FIB-4、APRI。