Liver Research Unit, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 199, Tung Hwa North Road, Taipei 10591, Taiwan.
Br J Cancer. 2012 Dec 4;107(12):2010-5. doi: 10.1038/bjc.2012.474. Epub 2012 Oct 18.
As most cases of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) have concurrent cirrhosis, viral factors identified to be associated with HCC might be related to cirrhosis rather than HCC.
Hepatitis B virus DNA levels, genotypes and precore/basal core promoter (BCP) mutants were compared between cirrhotic HCC and non-cirrhotic HCC patients. Age- and sex-matched case-control studies were performed to identify the risk factors.
Hepatitis B virus DNA levels showed no significant difference between non-cirrhotic HCC patients (n=20) and cirrhotic HCC patients (n=140) or 1 : 3 age- and sex-matched cirrhotic HCC patients (n=60), but genotype C and BCP mutant were significantly more prevalent in the latter than in the former. In multiple logistic regression, BCP mutant but not genotype C correlated significantly with the presence of cirrhosis in HCC patients. Compared with inactive carriers (n=60), non-cirrhotic HCC patients (n=20) had significantly higher HBV DNA levels but no difference in HBV genotypes and precore/BCP mutants. Furthermore, HBV DNA levels, the distribution of HBV genotypes and the prevalence of precore/BCP mutants all failed to show any significant difference between cirrhotic HCC patients (n=60) and cirrhotic patients without HCC (n=60).
Basal core promoter mutant is associated with progression to cirrhosis rather than HCC in chronic HBV infection.
由于大多数乙型肝炎病毒（HBV）相关肝细胞癌（HCC）都伴有肝硬化，因此与 HCC 相关的病毒因素可能与肝硬化有关，而与 HCC 无关。
比较了肝硬化 HCC 患者与非肝硬化 HCC 患者的乙型肝炎病毒 DNA 水平、基因型和前核心/基本核心启动子（BCP）突变体。进行了年龄和性别匹配的病例对照研究，以确定危险因素。
乙型肝炎病毒 DNA 水平在非肝硬化 HCC 患者（n=20）与肝硬化 HCC 患者（n=140）或年龄和性别匹配的肝硬化 HCC 患者 1:3 （n=60）之间无显著差异，但基因型 C 和 BCP 突变体在后者中明显更常见。在多因素逻辑回归中，BCP 突变体而非基因型 C 与 HCC 患者的肝硬化存在显著相关。与非活动携带者（n=60）相比，非肝硬化 HCC 患者（n=20）的 HBV DNA 水平显著升高，但 HBV 基因型和前核心/BCP 突变体无差异。此外，肝硬化 HCC 患者（n=60）与无 HCC 的肝硬化患者（n=60）之间的 HBV DNA 水平、HBV 基因型分布和 BCP 突变体的流行率均无显著差异。
在慢性 HBV 感染中，BCP 突变与进展为肝硬化有关，而与 HCC 无关。
