乙型肝炎病毒感染与原发性肝癌的关联性及危险因素分析

目的 研究乙型肝炎病毒感染与原发性肝癌间关联性,并对危险因素探讨.方法 慢性乙型肝炎病毒感染患者220例,其中慢性乙肝小三阳64例(小三阳组),慢性乙型肝炎大三阳62例(大三阳组),慢性乙型肝炎肝硬化50例(肝硬化组),乙型肝炎相关原发性肝癌44例(原发性肝癌组).观察4组乙肝病毒DNA不同含量(采用乙型肝炎病毒检测试剂盒检测)患者分布情况及表达水平;采用PCR扩增方法 检测4组患者乙肝病毒DNA含量,采用双抗体夹心酶联免疫吸附试验测定乙肝表面抗原.结果 4组患者乙肝病毒DNA不同含量患者分布比较差异有统计学意义(P<0.05),小三阳组DNA不同含量患者分布与大三阳组、肝硬化组、原发性肝癌组比较,差异有统计学意义(P<0.05).小三阳组乙肝病毒DNA表达水平高于大三阳组、肝硬化组和原发性肝癌组,差异有统计学意义(P<0.05),大三阳组乙肝病毒DNA表达水平高于肝硬化组,差异有统计学意义(q=3.884,P<0.05).4组患者乙肝表面抗原水平差异有统计学意义(P<0.05),小三阳组与大三阳、肝硬化组和原发性肝癌组比较,差异有统计学意义(P<0.05),大三阳组与肝硬化组和原发性肝癌组比较,差异有统计学意义(P<0.05).原发性肝癌组5～15年、>15年吸烟率,>15年饮酒率高于肝硬化组,不良饮食、e抗原阳性发生率高于肝硬化组,差异有统计学意义(P<0.05).结论 慢性乙肝小三阳、大三阳、肝硬化、原发性肝癌中,乙型肝炎病毒DNA水平和乙肝表面抗原呈下降趋势,长期吸烟、饮酒,不良饮食习惯和e抗原阳性是原发性肝癌发病的危险因素.

Correlation of Hepatitis B Virus Infection and Primary Liver Cancer and Risk Factors

Objective To study the relationship between hepatitis B virus infection and primary liver cancer,and to explore the risk factors.Methods 220 patients with chronic hepatitis B virus infection were selected,including 64 cases of chronic hepatitis(positive group),62 cases of chronic hepatitis B HBeAg(HBeAg positive group),50 cases of chronic hepatitis B cirrhosis(cirrhosis group),44 cases of hepatitis B primary hepatocellular carcinoma(PHC).PCR amplification method was used to detect hepatitis B virus DNA content of the 4 groups,and DAS-ELISA was used to detect hepatitis B surface antigen.Results Distribution of patients with different hepatitis B virus DNA content of the 4 groups had statistically significant difference(P<0.05),Distribution of patients with different hepatitis B virus DNA content of positive group and the other groups had statistically significant difference(P<0.05).Hepatitis B virus DNA expression level of positive group was higher than the other groups,the difference was statistically significant(P<0.05),the expression level of hepatitis B virus DNA of HBeAg positive group was higher than cirrhosis group,the difference was statistically significant(q=3.884,P<0.05).The difference was statistically significant in hepatitis B surface antigen levels among the 4 groups(P<0.05),positive group and the other groups had statistically significant difference(P<0.05),HBeAg positive group and liver cirrhosis group and HCC group had statistically significant difference(P<0.05).The rate of smoking was 5 years and >15 years in the primary liver cancer group,and the drinking rate was higher in the >15 group than that in the liver cirrhosis group.The incidence of adverse diet and e antigen was higher than that of the liver cirrhosis group,the difference was statistically significant(P<0.05).Conclusion In chronic hepatitis,HBeAg,cirrhosis,hepatocellular carcinoma,hepatitis B virus DNA and hepatitis B surface antigen gradually decrease,long-term smoking,drinking,unhealthy eating habits and e antigen are risk factors of primary liver cancer.