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目的探讨HBV基本核心启动子区(BCP)和前C区(PreC)变异与HBeAg阴性患者肝癌发生的关系。方法 204例HBeAg阴性患者分为A组(肝硬化肝癌,102例)、B组(非肝硬化肝癌,36例)和C组(慢性乙型肝炎,66例)。检测三组患者的HBV基因型及HBV BCP和PreC变异情况,分析HBV BCP和PreC变异与肝癌发生的关系。结果 A组中,HBV基因B型87例,C型14例,D型1例;B组中,HBV基因B型31例,C型5例;C组中,HBV基因B型54例,C型11例,D型1例。B组的A1896变异率高于C组(P<0.01)。单因素和多因素分析发现,A1896变异是非肝硬化肝癌发生的危险因素(P<0.01)。结论在HBeAg阴性患者中,A1896变异是非肝硬化肝癌发生的危险因素,对于肝癌的筛查有重要价值。
Objective To investigate the relationship between HBV core promoter region (BCP) and pre-C region (PreC) mutation and the occurrence of hepatocellular carcinoma in HBeAg-negative patients. Methods 204 cases of HBeAg-negative patients were divided into group A (liver cirrhosis, 102 cases), group B (non-cirrhosis of liver cancer, 36 cases) and group C (chronic hepatitis B, 66 cases). The genotype of HBV and the mutation of HBV BCP and PreC in three groups of patients were detected. The relationship between HBV BCP and PreC mutation and the occurrence of HCC was analyzed. Results In group A, there were 87 cases of HBV genotype B, 14 cases of type C and 1 case of type D. In group B, 31 cases of HBV genotype B and 5 cases of type C were found. In group C, HBV genotype B was 54 cases, 11 cases, type D in 1 case. The mutation rate of A1896 in group B was higher than that in group C (P <0.01). Univariate and multivariate analysis showed that A1896 mutation was a risk factor for non-cirrhotic liver cancer (P <0.01). Conclusion In the HBeAg-negative patients, A1896 mutation is a risk factor for the development of non-cirrhotic liver cancer, which is of great value for the screening of liver cancer.