襄阳地区乙肝肝癌流行状况调查及相关因素分析

目的了解乙型肝炎(简称乙肝)肝癌患者的流行病学特征并观察其血清学转换和乙型肝炎病毒DNA(HBV-DNA)变化趋势,探索乙肝病毒血清学转换与肝癌预后的关系。方法收集襄阳地区两家三甲医院乙肝肝癌患者病历,统计其吸烟史、饮酒史、家族史、感染乙肝时间,HBV-DNA定量检测结果和HBV血清学标志物检测结果,对仍在院的乙肝肝癌患者,用荧光定量PCR检测HBV-DNA水平和酶联免疫吸附测定法检测HBV血清学标志物。结果1475例乙肝肝癌患者中男性明显多于女性,51~60岁的人数最多;乙肝肝癌患者感染乙肝时间大多分布于10~<20年;HBV-DNA阳性率为61.47%,且HBV-DNA定量检测结果多位于103~106 copies/mL;最常见的乙肝“两对半”模式是“小三阳”;抗-HBs阳性的患者也不少,占12.17%;2013-2016年,HBV-DNA定量检测结果不同区间变化趋势不同。结论性别、年龄、家族史、感染时间是乙肝肝癌的高危因素。肝癌患者HBV-DNA检测结果多为阳性,需定期监测HBV-DNA载量并综合乙肝“两对半”及肝功能结果来指导抗病毒治疗。

Survey of hepatitis B hepatocellular carcinoma in Xiangyang and analysis of related factors

Objective To understand the epidemiological characteristics of patients with hepatitis B and liver cancer and observe their seroconversion and hepatitis B virus DNA(HBV-DNA)trends,and explore the relationship between hepatitis B virus serological conversion and liver cancer prognosis.Methods The medical records of patients with hepatitis B and liver cancer in two tertiary hospitals in Xiangyang were collected,and their smoking history,drinking history,family history,time of hepatitis B infection,HBV-DNA quantitative test results and HBV serological marker test results were collected.In patients,HBV-DNA content was measured by fluorescent quantitative PCR and HBV serological markers were detected by enzyme-linked immunosorbent assay.Results There were significantly more males than females in 1475 patients with hepatitis B liver cancer,and the largest number were 51 to 60 years old.Most patients with hepatitis B liver cancer were infected with hepatitis B from 10 to 20 years.The positive rate of HBV-DNA was 61.47%,and the quantitative test results of HBV-DNA were mostly located at 103-106 copies/mL.The most common"two and a half pattern"of hepatitis B was"little sanyang".There were also many anti-HBs positive patients,accounting for 12.17%.From 2013 to 2016,the HBV-DNA quantitative test results showed different trends in different intervals.Conclusion Gender,age,family history,and infection time are high risk factors for hepatitis B liver cancer.HBV-DNA test results of patients with liver cancer are mostly positive,and the HBV-DNA load should be monitored regularly and the results of HBV"two and a half pattern"and liver function should be used to guide antiviral treatment.