乙型肝炎后肝硬化并发原发性肝癌患者乙型肝炎病毒定量检测的临床意义
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摘要
目的探讨乙型肝炎后肝硬化并发原发性肝癌患者的乙型肝炎病毒指标定量检测的变化,以期为乙型肝炎后肝癌的早期诊断提供临床指导意义。方法采用回顾性分析方法,选取2015年2月—2016年2月在华北理工大学附属医院及唐山市传染病医院住院的乙型肝炎后肝硬化并发肝癌的患者59例,选择82例同期住院的单纯乙型肝炎后肝硬化患者作为对照。分析两组乙肝病毒标志物HBsAg、HBsAb、HBeAg、HBeAb、HBV DNA的差异。结果肝硬化并发肝癌组HBsAg、HBeAg的含量低于单纯肝硬化组,差异有统计学意义(P <0.05),两组患者HBsAb、HBeAb及HBV DNA的含量差异无统计学意义(P>0.05)。结论随着乙型肝炎后肝硬化病情的进展,HBsAg、HBeAg含量可能会逐渐降低,但这并不意味着病情得到控制或好转,有可能进展为肝癌,所以对病毒载量较低的乙型肝炎后肝硬化患者仍需积极抗病毒治疗,且应至少3个月复查1次乙型肝炎病毒标志物定量检测,以提高早期肝癌的检出率。
Objective To investigate the clinical significance of quantification of hepatitis B virus in patients with primary liver cancer. Methods Totally 59 patients with primary liver complicated by hepatitis B cirrhosis as well as 82 patients with simple hepatitis B cirrhosis who were admitted into our hospital during February 2015 to February 2016 were enrolled in this study as observation group and control group, respectively. HBV markers including HBsAg, HBsAb, HBeAg, HBeAb, and HBV DNA were measured. Results The content of HBsAg and HBe Ag in observation group was significantly decreased compapred with that in control group(P < 0.05). No obvious differences in HBsAb, HBeAb and HBV DNA were identified in two groups(P > 0.05). Conclusion Content of HBsAg and HBeAg may decrease along with the progression of hepatitis B cirrhosis, which may develop into liver cancer, however. Hepatitis B cirrhosis patients should continue on anti-virus treatment for further prevention of liver cancer.
Objective To investigate the clinical significance of quantification of hepatitis B virus in patients with primary liver cancer. Methods Totally 59 patients with primary liver complicated by hepatitis B cirrhosis as well as 82 patients with simple hepatitis B cirrhosis who were admitted into our hospital during February 2015 to February 2016 were enrolled in this study as observation group and control group, respectively. HBV markers including HBsAg, HBsAb, HBeAg, HBeAb, and HBV DNA were measured. Results The content of HBsAg and HBe Ag in observation group was significantly decreased compapred with that in control group(P < 0.05). No obvious differences in HBsAb, HBeAb and HBV DNA were identified in two groups(P > 0.05). Conclusion Content of HBsAg and HBeAg may decrease along with the progression of hepatitis B cirrhosis, which may develop into liver cancer, however. Hepatitis B cirrhosis patients should continue on anti-virus treatment for further prevention of liver cancer.
引文
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[11]JAROSZEWICZ J,CALLE SERRANO B,WURTHORN K,et al.Hepatitis B surface antigien(HBsAg)levels in the natural history of hepatitis B virus(HBV infection:a European perspective[J].Hepatology,2010,52(1):514-522.
[12]CHAN H L,WONG V W,TSE A M,et al.Serum hepatitis B surface antigen quantitation can reflect hepatitis B virus in the liver and predict treatment response[J].Clin Gastroenterol Hepatol,2007,5:1462-1468.
[13]NAUYEN T,DESMOND P,LOCARNINTI S.The role of quantitative hepatitis B serology in the natural history and management of chronic hepatitis B[J].HepatolInt,2009,3(Suppl):S5-S15.
[14]程晓光,张振华,王长泰,等.乙型肝炎表面抗原定量与原发性肝癌的相关性研究[J].安徽医学,2015,36(9):1058-1060.
[15]邓庆梅,高勇,何皖伟,等.原发性肝癌患者血清HBV标志物和HBV DNA测定的临床意义[J].实用肝脏病杂志,2012,15(5):414-416.
[2]PISANI P,BRAY F,PARKIN D M.Estimates of the world-wide prevalence of cancer for 25 sites in the adult population[J].Int JCancer,2002,97(1):72-81.
[3]LAVANCHY D.Worldwide epidemiology of HBV infection,disease burden,and vaccine prevention[J].J Clin Virol,2005,34(Suppl 1):S1-3.
[4]吕峰,郜玉峰,饶建国,等.乙型肝炎后肝硬化并发原发性肝癌患者临床特征比较[J].世界华人消化杂志,2015,23(17):2798-2804.
[5]中国抗癌协会肝癌专业委员会.原发性肝癌的临床诊断与分期标准[J].中华肝脏病杂志,2001,9(6):324-325.
[6]中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2015年更新版)[J].临床肝胆病杂志,2015,31:1941-1960.
[7]PARKER C,TONG SY,DEMPSEY K,et al.Hepatocellular carcinoma in Australia’s Northern territory:high incidence and poor outcome[J].Med J Aust,2014,201(8):470-474.
[8]ZHANG B H,YANG B H,TANG Z Y.Randomized controlled trial of screening for hepatocellular carcinoma[J].J Cancer Res Clin Oncol,2004,130(7):417-422.
[9]李鹏,丁惠国.肝癌危险因素及早期诊断与筛查[J].中国实用内科杂志,2015,35(3):193-195.
[10]董爱爱,赵洁,贾建伟,等.HBsAg定量检测在慢性HBV感染患者肝脏储备功能评价中的作用[J].世界华人消化杂志,2012,20(31):3033-3036.
[11]JAROSZEWICZ J,CALLE SERRANO B,WURTHORN K,et al.Hepatitis B surface antigien(HBsAg)levels in the natural history of hepatitis B virus(HBV infection:a European perspective[J].Hepatology,2010,52(1):514-522.
[12]CHAN H L,WONG V W,TSE A M,et al.Serum hepatitis B surface antigen quantitation can reflect hepatitis B virus in the liver and predict treatment response[J].Clin Gastroenterol Hepatol,2007,5:1462-1468.
[13]NAUYEN T,DESMOND P,LOCARNINTI S.The role of quantitative hepatitis B serology in the natural history and management of chronic hepatitis B[J].HepatolInt,2009,3(Suppl):S5-S15.
[14]程晓光,张振华,王长泰,等.乙型肝炎表面抗原定量与原发性肝癌的相关性研究[J].安徽医学,2015,36(9):1058-1060.
[15]邓庆梅,高勇,何皖伟,等.原发性肝癌患者血清HBV标志物和HBV DNA测定的临床意义[J].实用肝脏病杂志,2012,15(5):414-416.