摘要
目的探讨乙肝病毒A1762、G1764双突变是否可作为筛选HBsAg携带者肝癌最高危人群的生物学标记。方法对2 258名乙肝病毒无症状携带者进行前瞻性队列研究,其中HBV A1762、G1764双突变株组1 261人,野毒株组997人,跟踪随访队列,每6个月1次对观察对象抽血进行甲胎蛋白(AFP)检测及B超体检以检查肝癌发病情况。结果观察48个月,2 258名乙肝病毒无症状携带者中,共发生肝癌72例,突变株组64例,野毒株组8例,发病率分别为932.2/10万人年和203.5/10万人年,两组发病率差异有统计学意义(P<0.001),相对危险度(RR)为4.58。突变株组男性发病率1 827.8/10万人年,明显高于野毒株组的180.5/10万人年,两者比较差异有统计学意义(P<0.001),相对危险度为10.13。92.5%的男性病例有双突变;突变株组女性发病率为686.6/10万人年,高于野毒株组的233.3/10万人年,两组比较差异有统计学意义(P<0.05),但相对危险度仅为2.94。结论双突变是筛选男性HBsAg携带者中肝癌最高危人群的很好生物学标记,但对女性筛选肝癌高危人群的意义不如男性。
Objective To determine whether HBV core promoter double mutations（A1762,G1764） constitute a valuable biomarker to identity a subset of HBsAg carriers at extremely high risk of hepatocellular carcinoma（HCC）. Methods A cohort of 2 258 HBsAg positive subjects was recruited, which consist of HBV A1762, G1764 mutant group （n = 1 261 ）and wild type group （n = 997 ）. The study subjects were followed up 6-monthly with a purpose to diagnose HCC by measurements of serum alpha-fetoprotein levels and uhrasonographic examinations. Results Seventy-two cases of HCC were diagnosed after 48 months of follow-up. There were 64 cases in the mutant group and 8 cases in the wild-type group,giving HCC rates of 932.2/100 000 versus 203.5/100 000 person-years, respectively, the difference was signifieant（P 〈 0. 001 ）. The relative risk （RR） was 4.58. With further stratification according to gender, the incidence rates of male mutant group and male wild-type group were 1827.8/1（10 000 and 180. 5/100 000 person-years, respectively. The difference was also significant （P 〈0. 001 ）and RR was 10. 13. Specially ,92.5% （49/53）of the male cases in the cohort were infected with the mutant type. The incidence rates of female mutant group and female wild-type group were 686.6/100 000 and 233.3/100 000 person-years respectlvely,the difference was significant （P 〈0. 05） ,RR was only 2.94. Conclusion The data suggested that the double mutations （A1762、G1764）may be a good biomarker to identify a subset of male HBsAg carriers at extremely high risk of HCC but the value is less in female.
出处
《广西医学》
CAS
2011年第2期129-132,共4页
Guangxi Medical Journal
基金
英国Wellcome基金会资助项目(072058/Z/03/Z)
