目的：探讨乙型肝炎（乙肝）病毒（HBV）基本核心启动子区（BCP） A1762T／G1764A联合突变在不同疾病中发生的差异及其与乙肝相关肝癌预后的关系。方法选择慢性乙肝（CHB）患者38例、乙肝肝硬化（LC）患者36例、乙肝相关肝细胞肝癌（HCC）患者74例，用巢式PCR扩增患者血清中HBV BCP区，直接测序法检测HBV BCP区变异，分析A1762T／G1764A突变与HBV复制、HBeAg表达和 HBV感染不同阶段的关系，以及与 HCC患者预后的关系。结果在148例患者中，A1762T／G1764A突变总体发生率为54．7％，乙肝相关 HCC 组中 A1762T／G1764A 突变发生率为79．7％，而 CHB、LC 患者分别为31．6％、27．8％，HCC组变异的发生率明显高于CHB组（P＜0．05）和LC组（P＜0．05）；A1762T／G1764A突变组 HBV‐DNA载量与非突变组比较差异无统计学意义（ P＞0．05）；HBeAg 阳性组 A1762T／G1764A 突变发生率为41．4％，HBeAg 阴性组为73．5％，HBeAg阴性组变异发生率明显高于 HBeAg阳性组（P＜0．05）；HCC患者A1762T／G1764A变异组与非变异组之间无病生存期及总体生存期差异无统计学意义（P＞0．05）。结论 HBV核心启动子区A1762T／G1764A联合突变与 HCC发生具有显著关系，该变异与血清 HBV‐DNA的复制水平无关，但与血清 HBeAg表达水平有关，与乙肝相关HCC预后无显著关系。%Objective To explore the difference of the combined mutation occurrence of hepatitis B virus (HBV) based core pro‐moter(BCP) region A1762T/G1764A in different diseases and its relationship with prognosis of hepatitis B related hepatocellular carcinoma(HCC) .Methods Totally 148 patients were enrolled ,including 38 patients with chronic hepatitis B (CHB) ,36 cases with liver cirrhosis(LC) ,and 74 cases with hepatitis B related HCC were selected .Serum HBV BCP region was amplified by nested‐PCR and the variation was detection by using direct nucleotide sequence analysis .The relationship of A1762T/G1764A mutation with HBV duplication ,HBeAg expression and different stages of HBV infection and its relationship with HCC prognosis were analyzed . Results Of 148 patients ,the total occurrence rate of A1762T/G1764A mutation was 54 .7% ,which in the hepatitis B related HCC group was 79 .7% ,which in the patients with CHB and LC were 31 .6% and 27 .8% respectively ,the mutation occurrence rate in the HCC group was significantly higher than that in the CHB group (P<0 .05) and LC group(P<0 .05);the HBV‐DNA load had no statistical difference between the A1762T/G1764A mutation group and A1762T/G1764A non‐mutation group(P> 0 .05);the A1762T/G1764A mutation occurrence rate was 41 .4% in the HBeAg positive group and 73 .5% in the HBeAg negative group ,the latter was significantly higher than the former (P<0 .05);the disease‐free survival period and total survival period in the HCC pa‐tients had no statistical difference between the A1762T/G1764A mutation group and A1762T/G1764A non‐mutation group(P>0 .05) .Conclusion The combine mutation of HBV BCP region A1762T/G1764A has significant relation with HCC occurrence ,this variation has no relation with HBV‐DNA duplication level ,but has relation with serum HBeAg expression level ,moreover has no obvious relation with the prognosis of hepatitis B related HCC .
展开▼
