原发性肝癌合并与不合并肝硬化患者年龄及乙型肝炎病毒血清学特点比较

目的探讨原发性肝癌（PHC）合并肝硬化与无肝硬化患者年龄及HBV血清学特点。方法回顾性分析经影像学检查及甲胎蛋白（AFP）测定诊断为PHC的患者547例,分为有肝硬化和无肝硬化两组,统计分析并比较其年龄分布及HBV血清学标记的特点。结果合并肝硬化与无肝硬化患者分别为265例及282例,两组伴HBV感染者分别为221例、256例。合并肝硬化的肝癌患者男女比例为7.83∶1;60岁以下的男性肝癌患者年龄分布无明显差异,无肝硬化的男性肝癌患者60岁以上比例明显高于有肝硬化者（P〈0.005）。合并肝硬化的男性肝癌患者HBV感染率40岁以下年龄组最高（96.67%）,而HBeAg血清学转换率以40～60岁年龄段最高（89.47%）;无肝硬化者HBV感染率40～60岁年龄段最高（90.43%）,但HBeAg血清学转换率最低（80%）。结论合并肝硬化的PHC患者中,男性占大多数,而且早年HBV感染率高;无肝硬化的PHC患者中,老年人占多数;HBeAg血清学转换率高的人群肝癌发病率相对较高。

Differential distribution of age and HBV serological markers in liver cirrhosis and non-cirrhotic patients with primary liver cancer

Objective To compare the age distributions and presence of hepatitis B virus（HBV） serological markers between primary hepatic cancer（PHC） patients with and without liver cirrhosis.Methods A total of 547 PHC cases were analyzed retrospectively.After dividing into two groups according to liver cirrhosis status,the between-group differences in age and HBV serological markers,such as hepatitis B e antigen（HBeAg） status,were statistically compared using the Chi-squared test.Results The number of cirrhotic and non-cirrhotic PHC patients was 265 and 282,respectively.HBV infection was present in 221 cirrhotic PHC patients and 256 non-cirrhotic PHC patients（83.4% vs.90.8%）.There was a substantial bias in the proportion of males to females in the cirrhotic PHC patients（7.83∶ 1）.The number of PHC patients 60 years old was similar between the cirrhotic and non-cirrhotic groups,but the non-cirrhotic group had significantly more patients 60 years old（P0.005）.In cirrhotic PHC patients,the HBV infection rate was highest in the 40 years old age group（96.7%） and the HBeAg serological conversion rate was highest in the 40-60 years old age group（89.5%）.In non-cirrhotic PHC patients,the 40-60 years old age group showed the highest HBV infection rate（90.3%） but the lowest HBeAg serological conversion rate（80.0%）.Conclusion PHC with liver cirrhosis mainly occurred in males,with the HBV infection rate being higher in individuals 60 years old.Non-cirrhotic PHC patients were more often 60 years old.Many of the HBV-infected PHC patients with cirrhosis had high HBeAg serological conversion rate.