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华西医学  2015 

乙型肝炎病毒YMDD自然变异合并B、C基因型与乙型肝炎病毒相关肝细胞癌的关系

DOI: 10.7507/1002-0179.20150471, PP. 1650-1653

Keywords: 乙型肝炎病毒,乙型肝炎病毒相关肝细胞癌,基因型,YMDD变异

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Abstract:

目的?研究乙型肝炎病毒(HBV)YMDD自然变异合并B、C基因型与HBV相关肝细胞癌(HCC)的关系。方法?纳入2010年5月-2012年5月收治的未经任何核苷(酸)类似物治疗的HBV相关HCC患者110例以及慢性HBV感染者1079例(包括乙型肝炎携带者、慢性乙型肝炎、乙型肝炎肝硬化)。采用聚合酶链式反应(PCR)荧光杂交探针技术,通过DNA溶解温度值的差异区分血清HBV野生型和YIDD、YVDD两种耐药性突变株;采用型特异性探针Taqman荧光PCR技术检测血清HBVB、C型基因。根据不同资料类型分别采用t检验、χ2检验及非条件logistic回归分析进行统计学处理。结果?在110例HBV相关HCC患者中,检测出HBVYMDD自然变异、C型基因及YMDD自然变异合并C型基因患者分别为16例(14.5%)、39例(35.5%)和14例(12.7%),而在1079例慢性HBV感染者中,HBVYMDD自然变异、C型基因及YMDD自然变异合并C型基因患者分别为46例(4.3%)、153例(14.2%)和17例(1.6%),两组间差异均具有统计学意义(χ2=21.353,P<0.001;χ2=33.368,P<0.001;χ2=48.889,P<0.001)。非条件logistics回归分析表明,HBVC型基因感染者发生HCC的风险高于非C型基因OR=2.943,95%CI(1.778,4.872),P<0.001;具有HBVYMDD自然变异合并C型基因特征的感染者发生HCC的风险高于不具有该特征的患者OR=5.989,95%CI(2.394,14.980),P<0.001。结论?HBVYMDD自然变异合并C型基因是慢性HBV感染者发生HBV相关HCC的独立危险因素,对早期筛查HBV相关HCC高危人群具有重要的临床应用价值。

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