目的 探讨乙型肝炎(以下简称乙肝)肝硬化患者HBV DNA和肿瘤标志物相关性,为早期肝癌的诊断提供指导.方法 选取60例乙肝肝硬化和60例肝癌患者分别作为肝硬化组和肝癌组,采用PCR法检测HBV DNA,采用酶联免疫法检测甲胎蛋白异质体3(AFP-L3)和高尔基蛋白73(GP73).结果 肝硬化组的HBV DNA、AFP-L3和GP73的表达均明显低于肝癌组,差异有统计学意义(P<0.05),但HBV DNA和GP73阳性表达率与肝癌组相比,差异无统计学意义(P>0.05),AFP-L3的阳性率比较差异有统计学意义(P<0.05);Pearson相关分析显示HBV DNA定量与AFP-L3和GP73表达无明显相关性(rAFP-L3=0.422,P=0.192;rGP73=0.349,P=0.228);HBV DNA、AFP-L3、GP73和联合诊断的灵敏度、特异度和准确度分别为86.67%、20.00%、53.33%,68.33%、90.00%、79.17%,78.33%、30.00%、54.17%,68.33%、91.67%、80.00%.结论 乙肝肝硬化患者HBV DNA与AFP-L3、GP73表达无明显相关性,AFP-L3可用于鉴别肝癌和肝硬化,HBV DNA和GP73并不能区分乙肝病毒所致肝癌和肝硬化.%Objective To investigate the correlation between HBV DNA and tumor markers in patients with hepa-titis B ( HB) infection and liver cirrhosis , guidance for early diagnosis of liver cancer .Methods Sixty patients with hep-atitis B cirrhosis and 60 cases of liver cancer were selected as cirrhosis group and liver cancer group , respectively .The HBV DNA was detected by PCR method , and AFP-L3 and GP73 were detected using enzyme -linked immunoassay . Results The HBV DNA, AFP-L3 and GP73 expression were significantly lower in liver cirrhosis group than those of liver cancer group (P<0.05).But there was no significant difference in HBV DNA or GP 73 positive expression rate be-tween the 2 groups ( P>0.05 ) .There was significant difference in AFP -L3 positive rate between the 2 groups ( P<0.05).Pearson correlation analysis showed that HBV DNA quantitative and AFP -L3 and GP73 expression had no obvi-ous correlation (rAFP-L3 =0.422, P=0.192; rGP73 =0.349, P=0.228).The sensitivity, specificity and accuracy of HBV DNA, AFP-L3 and GP73, and the joint diagnosis were 86.67%, 20.00%and 53.33%;68.33%, 90.00%and 79.17%;78.33%, 30.00%and 54.17%; and 68.33%, 91.67% and 80.00%, respectively .Conclusion There is no significant correlation between HBV DNA and AFP -L3 or GP73 expression in hepatitis B cirrhosis patients , while AFP-L3 can be used to identify liver cancer and liver cirrhosis , HBV DNA and GP73 cannot distinguish liver cancer and liver cirrhosis caused by hepatitis B infection .
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