环氧化酶-2基因启动子区多态性与结直肠癌的易感性

目的:探讨环氧化酶-2(cyclooxygenase-2,COX-2)基因启动子区的-1195(G/A,rs689466)及3’非翻译区的8473(T/C,rs5275)2个位点的基因多态性与结直肠癌(colorectal cancer,CRC)发病风险的相关性.方法:采用病例-对照研究,利用聚合酶链式反应和限制性片段长度多态性(polymerase chain reaction-restrictive fragment length polymorphism,PCR-RFLP)分析方法,对343例CRC患者和340例健康人的COX-2基因的2个位点的多态性进行检测,采用SPSS11.0软件包统计分析各位点的基因型分布和等位基因频率.结果:COX-2-8473位点多态性的各基因型频率在病例组及对照组中分布均无显著差异(P>0.05),但COX-2-1195位点多态性的基因型频率在二组中分布有显著性差异(P<0.001),结果显示CRC患者COX-2-1195AG基因型在病例组的频率较对照组显著增高(校正后OR=2.23;95%CI:1.50-3.32),AA基因型在病例组中的频率亦较对照组高(校正后OR=2.46;95%CI:1.51-4.02),A等位基因携带者在病例组中的频率高于对照组(校正后OR=2.27;95%CI:1.55-3.34).各基因型分布在结肠癌及直肠癌中的分布无显著性差异(P>0.05).COX-2-1195A等位基因与淋巴结转移及TNM分期有显著相关性.结论:COX-2-1195位点AG/AA基因型是CRC的风险因素,且与CRC的淋巴结转移及TNM分期相关.     

环氧合酶-2基因启动子区单核苷酸多态性与非酒精性脂肪肝遗传易感性的关系

目的 通过检测环氧合酶-2(COX-2)基因启动子区单核苷酸的多态性,以探讨其与非酒精性脂肪肝(NAFLD)遗传易感性的关系.方法 对200例NAFLD患者和206名正常对照,采用多聚酶链反应-限制性片段长度多态性(PCR-RFLP)方法对COX-2基因启动子区-765G＞C和-1195G＞A多态性进行基因型分析.计量资料结果用均数±标准差((-x)±s)表示,经方差齐性检验后,行t检验;性别、基因型及等位基因频率的比较行x2检验.结果 正常对照中,COX-2基因启动子区-765G＞C和-1195G＞A等位基因的分布频率分别为48%和2%,NAFLD患者组二者分别为54%和5%.多变量Logistic回归分析显示:-765GC基因携带者与-765GG基因携带者相比较,前者发生NAFLD的比值比(OR)=2.35 (95% CI为1.17～3.65);-1195AA基因携带者与-1195GG基因携带者相比较,前者发生NAFLD的OR=1.13 (95% CI为1.01～2.46).与单体型G-1195-G765相比较,含有A1195的A-1195-C-765、A1195-G765两种单体型发生NAFLD的相对风险明显升高,OR分别为1.42 (95% CI为1.11～1.63,P＜0.05)和4.24(95% CI为1.72～14.22,P＜0.01).且A-1195-C765发生NAFLD的OR值高于A-1195-G-765、G-1195-C765的单体型.这一结果提示在同一单体型内-1195A与-765C之间存在交互作用.结论 COX-2基因启动子区的-1195G＞A和-765G＞C单核苷酸存在多态性,与NAFLD发生相关,是决定NAFLD个体遗传易感性的重要因素.     

基质金属蛋白酶-9基因多态性与乙型肝炎肝硬化的关系

目的 探讨基质金属蛋白酶（matrix metalloproteinase，MMP）-9基因启动子区多态性与乙型肝炎肝硬化的关系。方法应用PCR法和限制性片段长度多态性分析方法分别检测100例乙型肝炎肝硬化患者和124名正常对照者的MMP-9—1562C／T多态性，分析其基因型与乙型肝炎肝硬化发病风险相关性。结果 MMP-9—1562C／T多态性的基因型及等位基因频率在乙型肝炎肝硬化组和对照组间的分布差异无统计学意义（P〉0．05）。结论 MMP-9启动子1562位点基因多态性与乙型肝炎肝硬化易感无明显相关。     

血红素加氧酶-1基因启动子区多态性与冠心病和冠状动脉支架内再狭窄相关性的Meta分析

目的:探讨血红素加氧酶-1(HO-1)基因启动子区多态性与冠心病及冠状动脉支架内再狭窄(ISR)的相关性。方法:计算机检索PubMed、EMbase、CBM、CNKI、VIP和WanFang Data数据库,检索有关HO-1基因多态性与冠心病和冠状动脉ISR风险相关的研究,检索时限至2016年05月,采用Stata12.0软件进行Meta分析。结果:HO-1(GT)n重复序列多态性与冠心病相关性研究:共纳入13个病例-对照研究,包括7 835例冠心病患者和5 372例对照,Meta分析示在亚洲人群中HO-1(GT)n多态性与冠心病发病相关。HO-1(GT)n多态性与冠状动脉ISR相关性研究:共纳入6项前瞻性队列研究,包括972例ISR患者和4 052例对照,Meta分析示在亚洲人群中HO-1(GT)n多态性与ISR的发病风险具有相关性。HO-1T(-413)A单核苷酸多态性与冠心病相关性研究:共纳入4个病例-对照研究,包括3 323例冠心病患者和4 757例对照,Meta分析示HO-1T(-413)A多态性与冠心病的发病风险具有相关性。结论:在亚洲人群HO-1(GT)n重复序列多态性与冠心病和冠状动脉ISR风险具有相关性,携带短重复序列S或SS基因的人群其冠心病和ISR发病风险明显降低。HO-1T(-413)A与冠心病发病相关,携带A或AA基因的人群其冠心病发病风险明显降低。     

IL-10基因多态性与乙肝肝硬化易感性的相关性研究

探讨白细胞介素10(IL-10)基因多态性与乙型肝炎肝硬化易感性的关系.采用聚合酶链反应-限制性片段长度多态性(PCR-PFLP)分析方法,检测100例乙肝肝硬化患者及124例健康对照组IL-10基因启动子-1082G/A、-592A/C位点的基因多态性,并确定了其基因型和等位基因频率的分布.肝硬化组与对照组IL-10基因启动子-592A/C位点基因型分布频率和等位基因频率差异无显著性(P＞0.1),肝硬化组-1082G/A位点AA基因型频率及A等位基因频率高于对照组(P＜0.05),G等位基因相对于A等位基因患肝硬化的机会比为0.373(95%CI:0.166～0.838).IL-10基因多态性与肝硬化易感性相关,基因启动子-1082G/A位点AA基因型携带者肝硬化易感性高.     

肺结核患者肿瘤坏死因子-α基因多态性的研究

目的通过病例-对照研究,探讨肿瘤坏死因子-α(TNF-α)基因启动子区-238A/G、-308A/G位点单核苷酸多态性(SNP)与肺结核病的关系。方法采用序列特异性引物PCR(PCR-SSP)及测序技术检测深圳地区汉族人群肺结核患者200例及健康对照者197例TNF-α启动子区-238A/G、-308A/G位点基因多态性。采用直接计数法计算各组基因型频率及等位基因频率,并进行χ2检验;采用SHEsis软件进行单倍型分析。以P值0.05为具有统计学意义。结果2组人群TNF-α启动子区-238A/G、-308A/G位点基因型及等位基因分布频率差异无统计学意义(P0.05);两位点各种单倍型在2组间分布差异无统计学意义(P0.05)。结论TNF-α启动子区-238、-308位点基因多态性与中国汉族人群肺结核病易感性未见关联。     

白细胞介素-10基因多态性与乙型肝炎病毒感染的关系

目的:探讨中国人白细胞介素-10基因启动子单核苷酸多态性与乙型肝炎病毒感染之后临床发展之间的关系.方法:分别采用聚合酶链反应-限制性片段长度多态性分析法(PCR-RFLP)和聚合酶链反应-序列特异性引物扩增法(PCR-SSP)检测478例慢性乙型肝炎患者,223例乙肝病毒携带者及267例自限性感染者基因组DNAIL-10基因启动子区域3个多态位点-592、-819、-1082的基因多态性,并进行相关性分析.结果:IL-10-1082A等位基因及AA基因型在慢性乙型肝炎患者组的频率明显高于自限性感染者组和乙肝病毒携带者组(A:χ2=37.72,P=0.000;χ2=45.23,P=0.000;AA:χ2=20.53,P=0.000;χ2=19.14,P=0.000).IL-10-819T等位基因及TT基因型在慢性乙型肝炎患者组的频率也高于自限性感染者组和乙肝病毒携带者组(T:χ2=10.5,P<0.001;χ2=17.38,P<0.001;TT:χ2=8.76,P=0.003;χ2=5.656,P=0.017).IL-10-592C/A等位基因频率和AA/CC/AC基因型在三组的分布没有统计学意义(P>0.05).结论:IL-10基因启动子多态性与乙肝病毒感染后临床发展过程可能相关.     

环氧化酶-2基因多态性与冠心病易感性的相关性研究

目的探讨环氧化酶-2（COX-2）基因-765G/C多态性与冠心病易感性的关系。方法对226例经冠状动脉造影确诊的冠心病患者和240例正常人进行对照研究。应用聚合酶链反应限制性片断长度多态性技术测定COX-2基因-765G/C多态性。结果COX-2基因-765G/C多态性在冠心病组和正常人群（对照组）中分布的差异有显著性,冠心病组765G等位基因频率明显高于对照组（85.0%比79.4%,P〈0.05）。等位基因频率的相对风险分析发现,G等位基因携带者患冠心病的风险是C等位基因的1.471倍（95%CI：1.044-2.072）。结论COX-2基因启动子-765G/C多态性与冠心病发病具有相关性,其中G等位基因可能是冠心病发病的遗传易感基因。     

脂联素基因启动子区-11377 C/G多态性与2型糖尿病及糖尿病肾病的关系

目的探讨桂北地区汉族人群脂联素基因启动子区-11377 C/G单核苷酸多态性各基因型及等位基因频率分布,分析其与2型糖尿病（T2DM）及糖尿病肾病（DN）的关系。方法采用PCR-RFLP技术检测100例健康对照者及232例T2DM患者（其中DN 105例）的脂联素基因-11377 C/G位点基因型及等位基因频率分布。结果 T2DM患者脂联素基因启动子区-11377的GG基因型频率和G等位基因频率高于健康对照者（P〈0.05,Or=1.625,95%CI 1.05～2.51）;脂联素基因启动子区-11377基因型及等位基因频率分布在T2DM、DN患者间无统计学意义;T2DM患者CG＋GG基因型BMI高于CC基因型（P〈0.05）。结论脂联素基因启动子区-11377 C/G与桂北地区汉族人群T2DM发病有相关性,G等位基因可能是T2DM发病的遗传易感基因。     

N-甲基-D-天冬氨酸受体2B基因(GRIN2B)启动子区多态性与散发性阿尔茨海默病的相关性分析

目的探讨中国北方汉族人群N-甲基-D-天冬氨酸受体2B(N-methyl-D-aspartate receptor2B,NR2B)基因GRIN2B启动子区变异与散发性阿尔茨海默病(sporadic Alzheimer′s disease,SAD)的关系。方法利用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)的方法对中国北方汉族362例SAD患者和334名正常对照者进行GRIN2B启动子多态性及载脂蛋白E(ApoE)分型。结果中国北方汉族人群中GRIN2B启动子区存在-200T/G(rs1019385)、-421C/A(rs3764028)、-1447T/C(ENS10557853)和-1497G/A(rs12368476)多态性位点;-421C/A多态性在SAD和正常对照组中的基因型频率(P=0.029)和等位基因频率(P=0.010)差异显著;不携带ApoEε4的人群中-421C/A多态性的基因型频率(P=0.012)及等位基因频率(P=0.004)差异亦显著;所发现的4个多态性位点之间存在连锁不平衡关系,但其单体型分布在AD组和正常对照组中差异不显著。结论-421C/A多态性与AD发病有明显的相关性,在ApoEε4阴性的人群中这种相关性更为明显,-421C/A多态性可能独立于ApoEε4而影响SAD发病。     

Interleukin-10 promoter polymorphisms in patients with hepatitis B virus infection or hepatocellular carcinoma in Chinese Han ethnic population

BACKGROUND: Since single nucleotide polymorphisms (SNPs) can serve as gene markers, polymorphism profiles may help scientists to identify the full collection of genes that contribute to the development of complex diseases such as cancer. The distribution of interleukin-10 (IL-10) promoter polymorphisms in Chinese Han ethnic patients with hepatitis B virus (HBV) infection and hepatocellular carcinoma (HCC) was investigated in this study. METHODS: The polymorphisms of IL-10 promoter region were detected by pulymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and sequencing. Sixty-six health controls, 42 patients with HBV infection, 30 HCC patients, and cell line SMMC-7721 were examined this way. RESULTS: Polyrnorphisms of T/C or T/N on-872 site occurred frequently in Han ethnic population. Pulyrnorphisms were detected in HBV and HCC patients and cell line SMMC-7721. The hotspot among the pulymorphisms was inserting base A between-1058 and-1057. CONCLUSION: Polymorphisms of IL-10 promoter in HBV and HCC patients may be associated with HBV infection and HCC development.     

Association between polymorphisms of the APOBEC3G gene and chronic hepatitis B viral infection and hepatitis B virusrelated hepatocellular carcinoma

AIM to determine the relationship between five A3 G gene single nucleotide polymorphisms and the incidence of hepatitis B virus(HBV) infection and hepatocellular carcinoma(HCC). METHODS this association study was designed as a retrospective study, including 657 patients with chronic HBV infection(CHB) and 299 healthy controls. All subjects were ethnic Han Chinese. Chronic HBV-infected patients recruited between 2012 and 2015 at the First Hospital of Jilin University(Changchun) were further classified into HBV-related HCC patients(n = 287) and non-HCC patients(n = 370). Frequency matching by age and sex was performed for each group. Human genomic DNAwas extracted from whole blood. Gene polymorphisms were identified using a mass spectroscopic method.RESULTS there were no significant differences between the genotype and allele frequencies of the rs7291971, rs5757465 and rs5757463 A3 G gene polymorphisms, and risk of CHB and HBV-related HCC. the AG genotype and G allele for rs8177832 were significantly related to a decreased risk of CHB(OR = 0.67, 95%CI: 0.47-0.96; OR = 0.69, 95%CI: 0.50-0.95, respectively) and HCC(OR = 0.53, 95%CI: 0.34-0.84; OR = 0.58, 95%CI: 0.39-0.87, respectively). A significant relationship was found between rs2011861 computed tomography, tt genotypes and increased risk of HCC(OR = 1.69, 95%CI: 1.02-2.80; OR = 1.82, 95%CI: 1.08-3.06, respectively). Haplotype analyses showed three protective and four risk haplotypes for HCC. Also, one protective haplotype was found against CHB.CONCLUSION this study indicates that the A3 G rs8177832 polymorphism is associated with a decreased risk of CHB infection and HCC, while the rs2011861 polymorphism is associated with an increased risk of HCC.     

Strong influence of human leukocyte antigen (HLA)-DP gene variants on development of persistent chronic hepatitis B virus carriers in the Han Chinese population

Chronic hepatitis B virus (HBV) infection is a major health issue, especially in Asia. A recent genome-wide association study (GWAS) implicated genetic variants in the human leukocyte antigen (HLA)-DP locus associated with chronic hepatitis B in Japanese and Thai populations. To confirm whether the polymorphisms at the HLA-DP genes are associated with persistent chronic HBV infection in Han Chinese, we conducted an independent case-control study using 521 persistent chronic HBV carriers and 819 controls that included 571 persons with HBV natural clearance and 248 never HBV-infected (healthy) individuals. Eleven single nucleotide polymorphisms (SNPs) in a region including HLA-DPA and HLA-DPB and an adjacent SNP in strong linkage disequilibrium (LD) with a neighboring HLA-DR13 locus were genotyped using the TaqMan SNP genotyping assay. Eleven variants at HLA-DP showed a strong association with persistent chronic HBV carrier status (P = 1.82 × 10(-12) to 0.01). We also stratified the analysis by HBV clearance status to test the association between these polymorphisms and HBV natural clearance; similar results were obtained (P = 2.70 × 10(-11) to 0.003). Included SNPs define highly structured haplotypes that were also strongly associated with HBV chronic infection (block 1: odds ratio [OR] = 0.54, P = 8.73 × 10(-7) ; block 2: OR = 1.98, P = 1.37 × 10(-10) ). These results further confirm that genetic variants in the HLA-DP locus are strongly associated with persistent HBV infection in the Han Chinese population.     

A common HLA-DPA1 variant is a major determinant of hepatitis B virus clearance in Han Chinese

A recent genome-wide study showed that the single nucleotide polymorphisms (SNPs) in the HLA-DP region were associated with chronic hepatitis B virus (HBV) infection in Japanese and Thai persons. We tested the effects of HLA-DP SNPs for all major HBV outcomes in Han Chinese (n = 1742): HBV resistance, clearance, chronic infection, cirrhosis, and hepatocellular carcinoma. HLA - DPA1 rs3077 T was strongly associated with decreased risk of chronic HBV infection (odds ratio, .62; P = .001), consistent with the previous report. We showed for the first time to our knowledge that it is a predictor for HBV clearance (odds ratio, 2.41; P < .001). However, rs3077 was not associated with the development of cirrhosis or hepatocellular carcinoma.     

Role of Functional IFNL4, IFNLR1, IFNA,IFNAR2 Polymorphisms in Hepatitis B virus‐related liver disease in Han Chinese population

Recent studies show that variants in some interferon genes together with interferon receptor genes are associated with the outcome of infectious diseases. We examined the association between the risk of hepatitis B virus (HBV)‐related liver disease and the functional polymorphisms within IFNL4, IFNLR1, IFNA1, IFNA2, IFNA5 and IFNAR2 genes (14 loci in all) in a Han Chinese population. A total of 3128 people participated and were divided into 5 groups: healthy controls, natural clearance, chronic hepatitis B(CHB), liver cirrhosis and hepatocellular carcinoma (HCC). Significant associations were observed for 4 variants in IFNAR2, IFNLR1 with HBV infection, and IFNLR1‐rs4649203 was associated with HBV recovery. Moreover, we demonstrated the clear relevance of 5 polymorphisms in IFNA1, IFNA2, IFNL4 with HCC. Three SNPs in IFNL4 gene may be important susceptible factors for the progression of HBV‐related liver disease by trend chi‐square test. The IFNL4 haplotype conformed by rs12971396_G, rs8113007_T and rs7248668A was more frequent in HCC than CHB and LC group. Three polymorphisms in the 5′ region of the IFNL4 gene are associated with the progression of HBV‐related liver disease. IFNA1‐ rs1831583 and IFNA2‐ rs649053 are associated with the development of HCC. IFNLR1‐ rs4649203, rs7525481 are predictors for HBV infection, and rs4649203 is a predictor of spontaneous clearance. IFNAR2 ‐rs1051393, rs12233338 may be predictive markers of HBV infection in the Chinese population.     

汉族人群乙型肝炎病毒感染者外周血IL-28B基因多态性研究*

目的 分析乙型肝炎病毒（HBV）感染者外周血IL-28B基因型和等位基因频率分布,并探讨其与疾病病程和进展的关系。方法 本研究纳入江苏籍汉族健康人群145例和453例HBV感染者,后者包括无症状HBV携带者（ASC）45例,慢性乙型肝炎患者（CHB）181例,肝硬化（LC）患者69例,肝细胞癌（HCC）患者79例,乙型肝炎肝衰竭（LF）患者79例,采用PCR法和直接测序法检测外周血IL-28B基因rs12979860和rs8099917多态性位点。采用Pearson x²检验对IL-28B rs8099917与rs12979860位点进行Hardy-Weinberg平衡检验,计量资料以（x±s）表示,计数资料采用例数表示。应用SPSS 17.0软件进行方差分析、x²检验和Binary Logistic回归分析。结果 IL-28B基因rs12979860位点有CC、CT和TT 3个基因型,LF患者CC型和C等位基因频率分别为96.2%和98.1%,显著高于健康人群的87.6%和93.1%（OR=0.257,95%CI=0.068~0.973,P=0.045;OR=0.255,95%CI=0.070~0.928,P=0.038）;IL-28B基因rs8099917位点有TT 、TG和GG 3个基因型,LC患者TT型和T等位基因频率分别为92.8%和96.4%,显著高于健康人群的86.2%和92.4%（OR=0.288,95%CI=0.087~0.948,P=0.041;OR=0.299,95%CI=0.096~0.926,P=0.036）。结论 江苏地区汉族人群IL-28B基因多态性与HBV感染后不同疾病表型相关,IL-28B基因rs12979860的C等位基因和IL-28B基因rs8099917的T等位基因可能是HBV感染后病情进展的影响因素。     

Association of human leukocyte antigen polymorphism with hepatitis B virus infection and genotypes

Associations were studied between the polymorphism of northern Han Chinese leukocyte antigen (HLA) alleles and the outcomes of hepatitis B virus (HBV) infection and HBV genotypes. HLA-A, B, and DRB1 alleles in peripheral blood mononuclear cells (PBMCs) were detected by polymerase chain reaction (PCR) with sequence-specific primers. The PBMCs were collected from 61 persons who tested positive for hepatitis B surface antigen (HBsAg) for more than 6 months (Persistent group), 32 persons who tested negative for both HBsAg and HBV DNA but positive for both anti-HBc and anti-HBs (Recovered group), and 40 persons who tested negative for all serologic markers of HBV infection (Uninfected group). HBV genotypes in serum specimens from 56 of 61 patients with persistent HBV infection were determined by nested PCR with 6 pairs of HBV genotype-specific primers (A to F). The frequency of HLA-DRB1*12 was significantly higher in the Persistent group than in the Recovered group (P=0.004). HLA-A*02 was significantly higher in the Recovered group than in the Persistent group (P=0.044). HLA-DRB1*15 was significantly higher in the HBV genotype B group than in the C group (P=0.013). These findings suggested that there were associations not only between HLA polymorphisms and outcomes of HBV infection but also between HLA polymorphisms and the infected HBV genotypes.     

Childhood TB epidemiology and treatment outcomes in Thailand: a TB active surveillance network, 2004 to 2006

Background

Hepatitis B virus (HBV) infection is a significant public health problem that may lead to chronic liver disease, cirrhosis, and hepatocellular carcinoma (HCC). Approximately 30% of the world's population has been infected with HBV and approximately 350 million (5–6%) are persistent carriers. More than 120 million Chinese are infected with HBV. The role of host genetic factors and their interactions with environmental factors leading to chronic HBV infection and its complications are not well understood. We believe that a better understanding of these factors and interactions will lead to more effective diagnostic and therapeutic options.

Methods/Design

This is a population-based, case-control study protocol to enroll 2200 Han Chinese from medical centers in northern and western China. Adult subjects in the following groups are being enrolled: healthy donors (n = 200), HBV infected persons achieving virus clearance (n = 400), asymptomatic HBV persistent carriers (n = 400), chronic hepatitis B cases (n = 400), decompensated liver cirrhosis with HBV infection cases (n = 400), and hepatocellular carcinoma with HBV infection cases (n = 400). In addition, for haplotype inference and quality control of sample handling and genotyping results, children of 1000 cases will be asked to provide a buccal sample for DNA extraction. With the exception of adult patients presenting with liver cirrhosis or HCC, all other cases and controls will be 40 years or older at enrollment. A questionnaire is being administered to capture dietary and environmental risk factors. Both candidate-gene and genome-wide association approaches will be used to assess the role of single genetic factors and higher order interactions with other genetic or environmental factors in HBV diseases.

Conclusion

This study is designed and powered to detect single gene effects as well as gene-gene and environmental-gene interactions. The identification of allelic polymorphisms in genes involved in the pathway leading to chronic viral infection, liver cirrhosis and, ultimately, hepatocellular carcinoma would provide insights to those factors leading to HBV replication, liver inflammation, fibrosis, and the carcinogenic process. An understanding of the contribution of host genetic factors and their interactions may inform public health policy, improve diagnostics and clinical management, and provide targets for drug development.     

Interleukin-21 gene polymorphisms and chronic hepatitis B infection in a Chinese population

AIM: To investigate the relationship between inter-leukin-21(IL21) gene polymorphisms and chronic hepatitis B virus(HBV) infection in a Chinese population. METHODS: In this case-control study, 366 Chinese HBV-infected patients were recruited and divided into hepatocellular carcinoma(HCC; n = 94) and non-HCC(n = 272) groups at The First Affiliated Hospital of Sun Yat-Sen University, from April 2009 to December 2012. In the non-HCC group, the patients were classified into three clinical subsets, 76 patients had chronic hepatitis B, 101 were HBV carriers and 95 patients had HBV-related cirrhosis. Two hundred eight unrelated healthy controls were also included. Genomic DNA was extracted from peripheral blood. Single nucleotide polymorphisms(SNPs) rs13143866, rs2221903, and rs907715 were subsequently genotyped using the SNaP shot SNP technique.RESULTS: There were no significant differences in allele and genotype frequencies of SNPs rs13143866, rs2221903, and rs907715 between chronic HBVinfected patients and control subjects. Furthermore, no significant differences were found in the frequencies of all alleles and genotypes between the HCC group and the non-HCC group. However, in the subgroup analysis, IL21 rs13143866 genotype AA frequency in the HBV carrier group was higher than in controls(OR = 6.280, 95%CI: 1.238-31.854; P = 0.019), and the effect of the recessive model(AA vs GG + GA, OR = 6.505, 95%CI: 1.289-32.828) was observed in the HBV carrier group. IL21 rs2221903 genotype TC frequency in the HBV carrier group was higher than in controls(OR = 1.809, 95%CI: 1.043-3.139; P = 0.035). In the haplotype analysis, the ATA haplotype(rs13143866, rs2221903, and rs907715) of IL21 was more frequent in the HCC group than in the non-HCC group(0.165 vs 0.104, P = 0.044; OR = 1.700, 95%CI: 1.010-2.863).CONCLUSION: Genotypes rs13143866 AA and rs2221903 TC are risk factors for carrying HBV; ATA haplotype increases the risk of HBV-related HCC onsetin a Chinese population.     

乙型及丙型肝炎患者发生肝细胞癌的风险预测：REVEAL-HBV/HCV研究的回顾

乙型肝炎病毒（HBV）及丙型肝炎病毒（HCV）的慢性感染是肝细胞癌（HCC）的主要致病原因。全球约有3亿5千万人为HBV的慢性感染者;HCV慢性感染者则有2亿人。全球每年约有50万人死于乙型肝炎引起的HCC,另有25万人死于丙型肝炎引起的HCC。乙型肝炎慢性感染者,其血中HBV DNA及ALT持续处于高水平是HCC最重要的预测因子。其他的危险因子还包括HBV C基因型、HBV基础核心促进子A1762T/G1764A双突变、男性、老年、肝癌家族史、酗酒习惯、以及与HCV或人类免疫不全病毒的合并感染等。根据REVEAL-HBV研究的资料,我们发展出简单易用的列线图,可利用非侵入性的临床特征准确地预测慢性乙型肝炎患者发生HCC的风险。丙型肝炎慢性感染患者发生HCC最重要的预测因子包括高血中HCV RNA水平、高ALT水平、HCV基因型以及老年等。REVEAL-HCV研究案例中,与HCV RNA水平低于检测范围且低ALT水平者相比,HCV RNA可测得、高ALT水平且感染第一型病毒的案例具有最高的HCC发生风险,其多变项调整后的风险比值（95%CI）为21.87（5.09～93.95）,这些发现对于慢性丙型肝炎的临床处置具有重要的意义。