乙型肝炎病毒前核心/核心启动子突变及血清病毒载量在非肝硬化肝细胞癌中的作用：一项病例对照研究

Role of hepatitis B virus precore/core promoter mutations and serum viral load on noncirrhotic hepatocellular carcinoma: a case-control study.

作者信息

Liu Chun-Jen, Chen Bing-Fang, Chen Pei-Jer, Lai Ming-Yang, Huang Wen-Ling, Kao Jia-Horng, Chen Ding-Shinn

机构信息

Department of Internal Medicine, Division of Gastroenterology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei 100, Taiwan.

出版信息

J Infect Dis. 2006 Sep 1;194(5):594-9. doi: 10.1086/505883. Epub 2006 Jul 18.

DOI:10.1086/505883

PMID:16897657

Abstract

BACKGROUND

Apart from the presence of liver cirrhosis, hepatitis B virus (HBV) factors have also been shown to play a role in the development of hepatocellular carcinoma (HCC). Studying HBV-related noncirrhotic HCC may help clarify the effect of viral factors.

METHODS

In a hospital-based, age- and genotype-matched study, we aimed to determine the role played by basal core promoter (BCP) T1762/A1764 mutation, precore A1896 mutation, and serum viral load in noncirrhotic hepatocarcinogenesis by comparing 44 patients with HBV-related noncirrhotic HCC, 45 patients with chronic hepatitis B, and 42 patients with HBV-related cirrhotic HCC. HBV genotype, precore and BCP mutations, and viral load were determined by molecular assays.

RESULTS

In univariate analysis, statistically significant odds ratios were obtained for male sex (P=.005) and BCP T1762/A1764 mutation (P=.0003) in patients with noncirrhotic HCC, compared with patients with chronic hepatitis B. By multiple logistic regression analysis, male sex, BCP T1762/A1764 mutation, and viral load >or=10(5) copies/mL were independently associated with the risk of noncirrhotic HCC. The virologic characteristics were similar between patients with cirrhotic HCC and those with noncirrhotic HCC.

CONCLUSIONS

Our results suggest that BCP T1762/A1764 mutation and higher viral load may be involved in the carcinogenesis of cirrhotic and noncirrhotic HCC.

摘要

背景

除肝硬化外，乙型肝炎病毒（HBV）相关因素在肝细胞癌（HCC）的发生发展中也发挥作用。研究HBV相关的非肝硬化性HCC可能有助于阐明病毒因素的作用。

方法

在一项基于医院的年龄和基因型匹配研究中，我们旨在通过比较44例HBV相关的非肝硬化性HCC患者、45例慢性乙型肝炎患者和42例HBV相关的肝硬化性HCC患者，确定基础核心启动子（BCP）T1762/A1764突变、前核心A1896突变和血清病毒载量在非肝硬化性肝癌发生中的作用。通过分子检测确定HBV基因型、前核心和BCP突变以及病毒载量。

结果

在单因素分析中，与慢性乙型肝炎患者相比，非肝硬化性HCC患者的男性（P = 0.005）和BCP T1762/A1764突变（P = 0.0003）的优势比具有统计学意义。通过多因素逻辑回归分析，男性、BCP T1762/A1764突变和病毒载量≥10⁵拷贝/mL与非肝硬化性HCC风险独立相关。肝硬化性HCC患者和非肝硬化性HCC患者的病毒学特征相似。