Liu Chun-Jen, Chen Bing-Fang, Chen Pei-Jer, Lai Ming-Yang, Huang Wen-Ling, Kao Jia-Horng, Chen Ding-Shinn
Department of Internal Medicine, Division of Gastroenterology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei 100, Taiwan.
J Infect Dis. 2006 Sep 1;194(5):594-9. doi: 10.1086/505883. Epub 2006 Jul 18.
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.
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.
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.
Our results suggest that BCP T1762/A1764 mutation and higher viral load may be involved in the carcinogenesis of cirrhotic and noncirrhotic HCC.
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。
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。
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。
我们的结果表明，BCP T1762/A1764突变和较高的病毒载量可能参与了肝硬化性和非肝硬化性HCC的致癌过程。
