Liang R H, Lok A S, Lai C L, Chan T K, Todd D, Chiu E K
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam.
Hematol Oncol. 1990 Sep-Oct;8(5):261-70. doi: 10.1002/hon.2900080504.
This paper reviewed the clinical characteristics and treatment outcome of 484 lymphoma patients with known hepatitis B status. Comparisons were made between the hepatitis B surface antigen positive and negative patients. Also, the effect of treatment for lymphomas, including cytotoxic chemotherapy, in the hepatitis B antigen positive patients were analysed. The hepatitis B status was determined in 484 Chinese lymphoma patients at the time of initial diagnosis. Hepatic complications occurring during therapy for lymphomas were analysed. Although our lymphoma patients had a similar prevalence of hepatitis B markers of 42 per cent, they had a strikingly higher positive rate of 22 per cent for hepatitis B surface antigen and a relatively lower positive rate of 20 per cent for antibody, as compared to the respective figures of 9.5 per cent and 33 per cent in the control population. The hepatitis B surface antigen positive patients were younger than the negative patients but their treatment outcomes were similar despite the higher incidence of hepatic complications (21 per cent) in the hepatitis B surface antigen positive patients during therapy for lymphomas. None of the clinical parameters analysed appeared to be useful in predicting the development of these complications which included fatal liver failure (5.7 per cent), icteric hepatitis (5.7 per cent) and anicteric hepatitis (9.5 per cent). The high prevalence of hepatitis B surface antigen in our lymphoma patients may be related to the immunosuppressive effect of lymphomas. There is no definite evidence to suggest that hepatitis B infection has an aetiological or promoting role in the pathogenesis of lymphomas. Hepatitis B infection has contributed to the high incidence of hepatic complications during therapy for lymphomas and possible ways of prevention need to be investigated.
本文回顾了484例已知乙肝状况的淋巴瘤患者的临床特征及治疗结果。对乙肝表面抗原阳性和阴性患者进行了比较。此外，还分析了细胞毒性化疗等淋巴瘤治疗方法对乙肝抗原阳性患者的影响。在484例中国淋巴瘤患者初诊时确定其乙肝状况。分析了淋巴瘤治疗期间发生的肝脏并发症。尽管我们的淋巴瘤患者乙肝标志物的患病率相似，为42%，但与对照组人群中分别为9.5%和33%的相应数据相比，他们的乙肝表面抗原阳性率显著更高，为22%，抗体阳性率相对较低，为20%。乙肝表面抗原阳性患者比阴性患者年轻，但尽管乙肝表面抗原阳性患者在淋巴瘤治疗期间肝脏并发症的发生率较高（21%），他们的治疗结果相似。所分析的临床参数似乎均无助于预测这些并发症的发生，这些并发症包括致命性肝衰竭（5.7%）、黄疸型肝炎（5.7%）和无黄疸型肝炎（9.5%）。我们的淋巴瘤患者中乙肝表面抗原的高患病率可能与淋巴瘤的免疫抑制作用有关。没有确凿证据表明乙肝感染在淋巴瘤的发病机制中具有病因学或促进作用。乙肝感染导致了淋巴瘤治疗期间肝脏并发症的高发生率，需要研究可能的预防方法。
