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目的探讨乙型肝炎病毒(HBV)基因型、基本核心启动子(BCP)区双突变(简称BCP双突变)和肝硬化(LC)、肝细胞癌(HCC)发生的关联,分析BCP双突变和HCC临床病理特征的关系。方法随机收集233例慢性HBV感染者的血清,其中80例为慢性乙型肝炎(CHB)患者、75例为LC患者、78例为HCC患者,并系统整理患者的常规检查和病理等资料。采用实时荧光定量聚合酶链反应(FQ-PCR)检测BCP双突,用特异性引物多重PCR扩增确定HBV基因型。用SPSS 11.0分析结果。结果 HBV基因型结果均为B和C型,分别在CHB和LC组,CHB和HCC组间分布差异有统计学意义(P<0.05),在LC和HCC组间分布差异无统计学意义(P>0.05),感染C基因型与LC和HCC发生相关(分别OR=2.73,95%CI=1.29～5.82;OR=2.00,95%CI=0.98～4.09)。BCP双突变也分别在CHB和LC组,CHB和HCC组间分布差异有统计学意义(P<0.05),在LC和HCC组间分布差异无统计学意义(P>0.05),双突变与LC和HCC发生相关(分别OR=1.91,95%CI=0.96～3.82;OR=2.05,95%CI=1.04～4.06)。BCP双突变和伴肝硬化的HCC相关(P<0.05)。结论感染HBV C基因型、BCP双突变可能均是LC和HCC发生的危险因素,BCP双突变可作为LC和HCC早期预警生物标记物。
Objective To investigate the association between hepatitis B virus (HBV) genotype, double mutation of BCP region and cirrhosis and hepatocellular carcinoma (HCC) HCC clinical and pathological features of the relationship. Methods Sera from 233 patients with chronic HBV infection were randomly collected. Among them, 80 were chronic hepatitis B (CHB), 75 were LC and 78 were HCC. The routine examination and pathology were systematically collected. Double-stained BCP was detected by real-time fluorescence quantitative polymerase chain reaction (FQ-PCR), and HBV genotypes were determined by multiplex PCR amplification with specific primers. Analyze the results with SPSS 11.0. Results The results of HBV genotypes were B and C. The differences were statistically significant (P <0.05) between CHB group and LC group, CHB group and HCC group, but there was no significant difference between LC group and HCC group (P > 0.05). The genotype of infection C was correlated with the occurrence of LC and HCC (OR = 2.73, 95% CI = 1.29-5.82, OR = 2.00, 95% CI = 0.98-4.09, respectively). There were also significant differences in BCP double mutations between CHB group and LC group, CHB group and HCC group (P <0.05), but no significant difference between LC group and HCC group (P> 0.05) And HCC (OR = 1.91, 95% CI = 0.96 ~ 3.82; OR = 2.05, 95% CI = 1.04 ~ 4.06 respectively). BCP double mutations were associated with HCC with cirrhosis (P <0.05). Conclusion HBV C genotypes and BCP double mutations may be risk factors for LC and HCC. BCP double mutations can be used as early warning biomarkers for LC and HCC.