乙肝病毒前S1抗原检测在乙型肝炎向肝癌演变中的临床意义

目的探讨前S1抗原与原发性肝癌（PHC）的关系。方法采用ELISA法检测302例PHC患者的血清学乙肝病毒标志物（HBVM）及前S1抗原。结果302例PHC患者，HBVM检出率为99．0％（299／302）。其中单项阳性率HBsAg94．0％（284／302）、AntiHBs5．6％（17／302）、HBeAg20．2％（61／302）、AntiHBe72．8％（220／302）、AntiHBc97．4％（294／302）。61例HBeAg阳性样本中前S1抗原阳性46例（75．4％）；而196例HBeAg阴性AntiHBe阳性标本中前S1抗原阳性98例（50．0％）；而35例HBeAg和AntiHBe均阴性标本中前S1抗原阳性10例（26．3％）。前S1抗原在血清学表达上与HBeAg的阳性符合率高达75．4％。结论血清前S1抗原是乙型肝炎病毒（HBV）在体内复制的可靠标志，通过检测血清前S1抗原有助于提高认识PHC发生的可能性。

Determinations of PreS1 antigen in patients with hepatitis B and its clinical significance in tumorigenesis in primary hepatic cancer

Objective To investigate the clinical significance of PreS1 in tumorigenesis of primary hepatic cancer(PHC).Methods The hepatitis B virus and PreS1 were determined by ELISA method in serum of 302 PHC patients.Results Hepatitis B virus markers(HBVM) were detected in 299 of 302 PHC cases with a positive rate of 99.0%,among which HBsAg positive rate was 94.0%(284/302),AntiHBs 5.6%(17/302),HBeAg 20.2%(61/302),AntiHBe 72.8%(220/302) and AntiHBcAb 97.4%(294/302).In 46 out of 61 HBeAg positive patients PreS1 antigen was positive with a positive rate of 75.4%,98 out of 196 HBeAg negative and Anti-HBeAb positive cases had positive PreS1 with a positive rate of 50.0%.Only 10 cases were found with positive PreS1 in both HBeAg and Anti-HBe negative cases.The coincidence rate of PreS1 and HBeAg was 75.4%.Conclusion PreS1 antigen is the relicable marker of hepatitis B virus in patients with hepatitis B.