乙肝病毒C基因启动子基因变异的检测及临床意义

目的建立等位PCR检测HBVC基因启动子（BCP）基因碱基变异的方法，并探讨检测其基因突变对于乙肝病人临床治疗的意义。方法在3’端设计和合成与野生和突变碱基互补的引物，建立等位PCR检测碱基变异的方法，并通过核苷酸序列测定进行对比来检测慢性和急性乙肝病例、肝癌病例的血清样本。结果经统计学处理该检测方法与核苷酸序列测定所得的结果，得到x^2=0．004，P〉0．05，差异不显著。急性和慢性乙肝病例、肝癌病例的临床血清样本的检测结果为BCP基因碱基变异比例分别为3．9％、26．7％、41．2％，其中1762位及1764位双突变型血清样本在肝癌病例中的比例比慢性乙肝病例高，且有统计学意义。结论该等位PCR检测HBVC基因启动子变异的方法适用于临床血清样本检测，结果可靠且简便易行。BCP基因1762位及1764位突变的检测结果说明这两个突变与乙肝以及其后期发展为肝癌正相关。通过检测这两个突变可预测病情发展，对指导临床治疗有显著的意义。

Detection hepatitis B virus C gene promoter gene mutation and its clinical implication

Objective To establish allelic PCR detection methed of the HBV BCP gene with mutated bases in order to investigate the signifcance of this detecting method for HBV patients＇ clinical treatment. Methods The complementary primers of wild and mutant type were designed in the 3＇ end, the mutation detected by allele-specific PCR and sequencing were compared among different serum samples of chronic and acute hepatitis B and liver cancer cases. Results Using statistical methods to deal with the results of the detection method and nucleotide sequencing, we got ~ 2=0.004, P〉 0.05 and the difference was not significant. The serum samples of acute hepatitis cases, chronic hepatitis B cases and liver cancer cases were detected, and the proportion of mutated BCP gene in them were 3.9%, 26.7% and 41.2%, respectively. The proportion of samples with site 1762 and 1764 double mutation was higher in liver cancer cases than in chronic HBV cases. Conclusion Allelic PCR detection for HBV BCP gene with mutated bases is suitable for clinical tests and the results are reliable. BCP1762 and 1764 gene mutation test results indicate that these two sites＇ mutation are related to the development of liver cancer and hepatitis B and they can be uesd to predicte the disease progression and to guide the clinical treatment.