Objective To understand the mutation of hepatitis B virus X gene by gene sequencing from HBV infected serum. Methods HBV DNAs were extracted from the serum of 133 infectors from Panyu area, and HBV X genes were amplified by PCR and then sequenced. According to the different courses of disease, patients were divided into four groups:36 cases of hepatitis B virus carrier (ASC), 40 cases of chronic hepatitis (CHB), 34 cases of liv-er cirrhosis (LC) and 23 cases of hepatocellular carcinoma (HCC). And the results were comprehensively and compara-tively analyzed. Results The mutation numbers per capita of four groups were as follows:ASC group (5.17 ± 0.86), CHB group (5.05±0.80), LC group (3.43±0.86) and HCC group (2.05±0.44). And there were no statistically significant difference between the ASC group, CHB group and LC group (P>0.05), while the number in HCC group was lower than that in the other three groups (P<0.05). The top 4 sites of HBV X gene mutation detection rates were:85 cases of A1762T/G1764A double mutation (63.91%), 77 cases of T1719G/G1721A simultaneous mutation (57.89%), 62 cases of T1544A (46.62%) and 45 cases of T1753C (33.83%). The top 4 sites of mutation detection rates were all highest in LC group (P<0.05). Conclusion Detection of the high mutation site of HBV X gene could help provide clues for study-ing the mechanism of liver cirrhosis and liver cancer, which also presents significant reference for clinical practice.%目的：对乙型肝炎病毒(HBV)感染者血清标本的HBV X基因进行测序，以了解其突变情况。方法从广州市番禺区133例HBV感染者的血清标本中提取HBV DNA，以PCR方法扩增HBV X基因，再进行测序，根据患者不同病程将其分为乙肝携带组(ASC组)36例、慢性肝炎组(CHB组)40例、肝硬化组(LC组)34例和肝癌组(HCC组)23例，并对结果进行综合比较分析。结果人均碱基突变数ASC组为(5.17±0.86)、CHB组为(5.05±0.80)、LC组为(3.43±0.59)，HCC组为(2.05±0.44)，ASC组、CHB组和LC组比较差异均无统计学意义(P>0.05)，而HCC组均低于ASC组、CHB组、LC组，差异均有统计学意义(P<0.05)；HBV X基因突变检出率排前4位的位点是：A1762T联合G1764A双变异为85例(63.91%)，T1719G联合G1721A同时变异为77例(57.89%)，T1544A为62例(46.62%)，T1753C为45例(33.83%)。前4位突变检出率均在LC组中最高(P<0.05)。结论对HBV X基因的高突变位点进行检测为肝硬化及肝癌的发病机制提供线索，对尽早预防和预测肝硬化及肝癌具有重要意义。
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