TT病毒与原发性肝细胞癌发病的关系

目的探讨TT病毒(TTV)感染与原发性肝细胞癌(HCC)之间的关系.方法使用第二代TTV PCR引物,从112例HCC患者、95例无HCC的慢性肝病(CLD)患者及30例健康志愿者血清中检测TTV,每份DNA样本均取自50μl血清.记录各组患者的临床特点(性别、年龄、肝功能、肿瘤特性、其他肝炎病毒指标和输血史),并分析其与TTV感染的关系.结果 (1)TTV DNA在HCC患者的阳性检出率为17.86%(20/112),与在无HCC的CLD患者中的阳性检出率15.78%(15/95)相比,差异无显著性,但均较正常对照组有显著差异(P＜0.05);(2)在输血史这一临床特征上,HCC和CLD组内,TTV DNA阳性与阴性组之间差异有显著性,分别为80.00%vs 35.87%(P＜0.05)和73.33% vs 27.50%(P＜0.05);(3)在HCC患者中,TTV DNA阳性组丙氨酸氨基转移酶(ALT)较阴性组有显著升高,(93±27)IU/L vs (68±31)IU/L](P＜0.05),且TTV DNA的存在造成同时合并HBV和/或HCV感染的HCC患者ALT的显著升高(P＜0.05);(4)在CLD患者中,有无TTV DNA的存在,对HBV和/或HCV所致的肝功能损伤并无显著性影响.结论 TTV这种可能经过血液传播的肝炎病毒可造成HCC患者的肝功能损伤,但在CLD向HCC的转化中,似乎不起主导作用.

Relationship between TT virus infection and hepatocellular carcinoma

OBJECTIVE: To clarify the relationship between TT virus (TTV) infection and the development of hepatocellular carcinoma (HCC). METHODS: TTV was examined in sera of 112 patients with HCC and 95 patients with chronic liver disease (CLD) without HCC. 30 patients without liver disease were examined as control. TTV DNA was detected by the second generation of TTV PCR primers (NG059, NG061 and NG063) after extraction of DNA from 50 microliters serum. The relationship between TTV infection and clinical features of each group patients was analyzed. RESULTS: TTV DNA was detected in 17.86% (20/112) of HCC patients, and this prevalence in HCC patients was not significantly higher than that of TTV DNA in CLD patients (15.78%, 15/95). There were no significant differences in age, gender, tumor factors (size, TNM classification and markers) and other hepatitis virus markers between TTV-positive and TTV-negative in HCC and CLD patients, except history of blood transfusion (80.00% vs 35.87% (P < 0.05) in HCC patients and 73.33% vs 27.50% (P < 0.05) in CLD patients)] and ALT (93 +/- 27) IU/L vs (68 +/- 31) IU/L (P < 0.05) in HCC patients]. It seemed that TTV did not do any harm to the liver function of patients who infected with HBV or HCV, except for elevating ALT level in such a kind of HCC patients. CONCLUSION: Although TTV could do harm to the liver function of HCC patients, it does not contribute to the development of HCC from CLD.