摘要
目的:研究HBeAg阴性与HBeAg阳性的原发性肝癌患者临床特点和病毒相关因素的差异,并探讨研究其临床意义.方法:对1356例原发性肝癌患者的门诊及住院病历进行回顾性调查,以HBeAg阴性的原发性肝癌患者为对照组,HBeAg阳性的原发性肝癌患者为试验组.分析两组上消化道出血率、AFP水平、乙型肝炎病毒DNA定量和肝组织病理学指标的差异.结果:HBeAg阴性原发性肝癌996例,占73.4%;HBeAg阳性原发性肝癌360例,占26.6%.HBeAg阴性组合并上消化道出血的比例为22.2%,显著高于HBeAg阳性组的11.9%(χ2=17.70,P<0.01).HBeAg阳性组乙型肝炎病毒DNA定量在各级对数值上均显著高于HBeAg阴性组(χ2=298,P<0.005).HBeAg阴性组肝纤维化分期≥3的比例为46.9%,高于HBeAg阳性组的33.1%(χ2=7.27,P=0.007).AFP水平在两组间无明显差异.结论:HBeAg阴性原发性肝癌肝组织学损害程度重于HBeAg阳性原发性肝癌,更易合并肝性门静脉高压症所致的上消化道出血,预后较差.HBeAg阴性患者更要警惕原发性肝癌的发生.
AIM： To investigate the clinical and virological characteristics of HBeAg-negative and HBeAg- positive primary hepatic cancer （PHC）, and to explore their clinical significance.
METHODS： A total of 1356 out-patient and inpatient PHC cases were retrospectively analyzed. HBeAg-negative cases were taken as control group while HBeAg-positive cases were the test group. The upper alimentary canal bleeding rate, serum AFP values, HBV DNA levels were analyzed between the two groups.
RESULTS： Of the 1356 cases, 996 （73.4%） were HBeAg-negative（control group） and 360 （26.6%）were HBeAg-positive （test group）. Compared with the test group, there was a significantly higher upper alimentary canal bleeding rate （11.9% vs 22.2%,χ^2 = 17.70, P 〈 0.01）, a significantly lower DNA levels （χ^2 = 298, P 〈 0.005） in the control group. And the cases of hepatic fibro- sis staging ≥ 3 were also higher in the control group than in the test group （46.9% vs 33.1%, χ^2 = 7.27, P 〈 0.007）. No obvious difference in AFP levels was observed between the control group and the test group.
CONCLUSION： Hepatic tissue injury is more serious in HBeAg-negative patients than HBeAg- positive patients, and HBeAg-negative patients have greater tendency of developing portal hypertension-associated upper alimentary canal bleeding with a poor prognosis and HBeAg-neg- ative patients should be warned against primary hepatic cancer.
出处
《世界华人消化杂志》
CAS
北大核心
2008年第32期3696-3699,共4页
World Chinese Journal of Digestology
关键词
原发性肝癌
肝炎E抗原
上消化道出血
DNA
组织学
AFP
Primary hepatic cancer
Hepatitis B e antigens
Upper alimentary canal bleeding
DNA
Histology
AFP
