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目的分析HBV基因型及基因变异与原发性肝癌(PHC)发病的关系。方法采用基因型特异引物PCR法测定HBV基因型,限制性酶切片段长度多态性检测基因亚型;直接测序法检测HBV DNA 1653、1762/1764及1896位点的变异情况;统计比较多个因素在慢性乙型肝炎(CHB)和PHC患者中的异同,并进行危险因素分析。结果与CHB组比较,PHC组患者年龄较大,HBeAg阴性更常见,而ALT水平和HBV DNA载量较低(P<0.05)。CHB组HBV的基因型B型与C型相当,而PHC组绝大多数为C型(P<0.01);两组基因型C型的亚型多为Ce亚型。两组病毒G1896A变异无差异,而PHC组C1653T、A1762G/T1764A变异出现的几率较高(P<0.05)。Logistic回归分析表明只有基因C型和高龄为PHC的独立危险因素。结论 HBV基因型C型为HBV相关PHC发病的独立危险因素;C1653T、A1762G/T1764A变异与PHC有一定相关,但非独立危险因素。
Objective To analyze the relationship between HBV genotype and gene mutation and the incidence of primary liver cancer (PHC). Methods HBV genotypes were detected by genotyping PCR and restriction fragment length polymorphism (PCR-RFLP). Genotype-specific PCR was used to detect HBV genotype. HBV DNA 1653, 1762/1764 and 1896 were detected by direct sequencing. Factors in Chronic Hepatitis B (CHB) and PHC patients in the similarities and differences, and risk factors. Results Compared with CHB group, patients in PHC group were older, HBeAg negative were more common, while ALT level and HBV DNA load were lower (P <0.05). HBV genotype B in CHB group was the same as that of C genotype, but the vast majority of PHC genotype was C genotype (P <0.01). The genotype C genotype of both genotypes was mostly Ce subtype. There was no difference in G1896A mutation between the two groups, but there was a higher probability of C1653T and A1762G / T1764A mutation in PHC group (P <0.05). Logistic regression analysis showed that only genotype C and age were independent risk factors for PHC. Conclusion HBV genotype C is an independent risk factor for HBV-related PHC. C1653T and A1762G / T1764A mutations are related to PHC but not independent risk factors.