乙型肝炎相关性肝癌患者血清低拷贝HBV DNA检测的临床分析

发布时间：2018-08-03 13:02

【摘要】：目的通过对乙型肝炎相关性肝癌(HCC)患者血清低拷贝HBV DNA的检测,探讨乙肝病毒低复制水平与肝癌发生、发展的相关性,明确乙型肝炎患者血清低拷贝HBV DNA检测的临床意义。方法在所有乙型肝炎相关性HCC患者中,选取85例血清HBV DNA水平持续小于1 000 IU/ml的患者,对其病情发生、发展、演变进行系统的回顾分析,同时获得其血清,进行乙型肝炎标志物、肝功能、甲胎蛋白及低拷贝HBV DNA的检测,最后分析各项指标与低拷贝HBV DNA的相关性,分析其临床意义。结果 85例乙型肝炎相关性HCC患者当中,乙型肝炎标志物HBe Ag阳性者有15例,占17.65%,HBe Ag阴性者70例,占82.35%。肝功能指标(ALT及AST)异常者52例,占61.18%。甲胎蛋白(AFP)异常升高者65例,占76.47%。低拷贝HBV DNA水平大于20 IU/ml者72例,占84.71%。低拷贝HBV DNA水平小于20 IU/ml者13例,占15.29%。结论乙型肝炎相关性HCC与乙型肝炎病毒持续复制有关,常规的HBV DNA检测只能检测HBV DNA水平大于1 000 IU/ml的患者,乙肝病毒低复制患者往往会被忽视,导致患者不能及时抗病毒治疗而使得病情发展。因此这种检测已不能满足临床的实际要求,乙型肝炎患者低拷贝HBV DNA检测更有临床指导意义。
[Abstract]:Objective to investigate the relationship between the low replication level of hepatitis B virus (HBV) and the occurrence and development of hepatocellular carcinoma (HCC) by detecting serum low copy HBV DNA in patients with hepatitis B related hepatocellular carcinoma (HCC), and to determine the clinical significance of low copy HBV DNA detection in serum of patients with hepatitis B. Methods among all patients with hepatitis B related HCC, 85 patients with hepatitis B related HCC whose serum HBV DNA level was less than 1 000 IU/ml were selected. The occurrence, development and evolution of the disease were analyzed systematically, and their serum was obtained at the same time. Hepatitis B markers, liver function, alpha-fetoprotein and low copy HBV DNA were detected. Finally, the correlation between the indexes and low copy HBV DNA was analyzed and its clinical significance was analyzed. Results among 85 patients with HCC associated with hepatitis B, 15 cases were positive for HBe Ag, 70 cases were negative for HBe Ag, accounting for 82.35%. Abnormal liver function indexes (ALT and AST) were found in 52 cases (61.18%). 65 cases (76.47%) had abnormal elevation of alpha-fetoprotein (AFP). The low copy HBV DNA level was more than 20 IU/ml in 72 cases (84.71%). Low copy HBV DNA level was less than 20 IU/ml in 13 cases (15.29%). Conclusion Hepatitis B related HCC is related to the continuous replication of hepatitis B virus. Routine HBV DNA detection can only detect patients whose HBV DNA level is more than 1 000 IU/ml. Patients with low replication of hepatitis B virus are often ignored. Causes the patient to be unable to treat in time the antivirus causes the condition to develop. Therefore, this detection can not meet the actual clinical requirements, hepatitis B patients with low copy of HBV DNA detection is more clinical significance.
【作者单位】：浙江省人民医院感染科;杭州市第六人民医院感染科;杭州市第六人民医院检验科;
【基金】：浙江省杭州市科技局重点专科专病项目(2010-0733Q15)
【分类号】：R512.62;R735.7

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