AASLD2020[835]患者S1前檢測的臨床意義 慢性乙型肝炎病毒感染

StephenW

835
CLINICAL SIGNIFICANCE OF PRE-S1 DETECTION IN PATIENTS
WITH CHRONIC HEPATITIS B VIRUS INFECTION
Xingxin Zhang1, Qian Wei1, Yirong Cao2, Jiyao Wang1 and
Jinsheng Guo1, (1)Department of Gastroenterology and
Hepatology, Zhongshan Hospital, Fudan University, Shanghai
Institute of Liver Diseases, (2)Department of Gastroenterology
and Hepatology, Huadong Hospital, Fudan University
Background: Pre-S1 antigen of hepatitis B (pre-S1) is a
component of large surface antigen of hepatitis B virus
(L-HBsAg) In this study, we investigated the correlation
between pre-S1 status and the unfavorable prognosis of
chronic hepatitis B(CHB) infection, including cirrhosis and
hepatocellular carcinoma(HCC) Methods: 840 patients
with chronic HBV infection who visited Zhongshan Hospital
Affiliated to Fudan University from 2016 to 2019 were enrolled
in this study The clinical data of HBV infection, liver function,
blood routine test, coagulation function, liver cancer markers,
hepatobiliary ultrasound, CT or MRI imagings were collected
Single factor analysis and logistic multiple regression analysis
were applied to explore the correlation between pre-S1 status
and other HBV markers, and the risk of cirrhosis and HCC
The correlation between pre-S1 transversions in 144 patients
that had multiple follow-up data and their prognostic events,
anti-HBV drug treatment, and other HBV markers, were also
analyzed T test and Wilcoxon rank sum test were used to
compare the means of measurement data Chi square test
and Fisher exact test were used to compare the average levels
of counting data Stata 14 2 software was used for statistical
analysis Results: 1) Quantitative HBsAg was significantly
higher in the Pre-S1 positive group than in the negative
group (Z=-15 983, P=0 000) The single test Pre-S1 positive
rates within the interval of HBsAg<1000COI, 1000~2000COI,
2000~5000COI, >5000COI were significantly different (7.28%,
42 53%, 71 31%, 87 43%, c2=317 9634, P=0 000) Similarly,
the single test Pre-S1 positive rates within the interval of HBV
DNA levels <10^3 IU/ml, 10^4~10^5 IU/ml, and 10^6~10^8 IU/
ml were also significantly different (61.34%, 74.70%, 86.36%,
c2=15 7447, P=0 000) The positive rate of HBeAg in pre-S1
positive group was higher than that in pre-S1 negative group
( c2=20 8575, P=0 000) 2) The results of logistic multiple
regression analysis showed that single pre-S1 test negative
(OR=1 7), male gender (OR=3 9), Sustained Pre-S1 negative
in multiple follow-up tests (OR=6 3), age and quantitative
HBsAg were associated with HCC risk 4) There were no
association between anti-HBV drugs treatment with Pre-S1
transversions (c2=4.8954, P=0.180). No significant association
was found between pre-S1 status or transversions with the
risk of cirrhosis Conclusion: Pre-S1 positive reflects the
existence of HBV and viral replication, which is similar to
other HBV markers including HBsAg, HBeAg and HBV DNA
Currently oral anti-HBV drugs have no significant impact on
Pre-S1 status or its serological transversions It should be
notified that sustained pre-S1 and HBsAg, and/or HBV DNA
positive reflects HBV un-clearance, and sustained pre-S1
negative with HBsAg positive are associated with a higher
HCC risk in CHB patients.

StephenW

835
患者S1前檢測的臨床意義
慢性乙型肝炎病毒感染
張興新1，錢偉，曹一榮2，王繼堯1和
郭金生1，（1）消化內科
復旦大學附屬中山醫院肝病科，上海
肝病研究所，（2）消化內科
復旦大學附屬華東醫院肝膽科
背景：乙型肝炎的前S1抗原（pre-S1）是一種
乙型肝炎病毒大表面抗原的組成
（L-HBsAg）在這項研究中，我們調查了相關性
在S1之前的狀態和預後不良之間
慢性乙型肝炎（CHB）感染，包括肝硬化和
肝細胞癌（HCC）方法：840例
慢性HBV感染的中山醫院
復旦大學附屬於2016年至2019年入學
在這項研究中HBV感染，肝功能，
血液常規檢查，凝血功能，肝癌標誌物，
收集肝膽超聲，CT或MRI影像
單因素分析和邏輯多元回歸分析
用來探討S1之前狀態之間的相關性
和其他乙肝病毒標誌物，以及肝硬化和肝癌的風險
144例患者的S1換位前的相關性
具有多個隨訪數據及其預後事件，
抗HBV藥物治療和其他HBV標誌物
用T檢驗和Wilcoxon秩和檢驗進行分析。
比較測量數據的方法卡方檢驗
和Fisher精確檢驗用於比較平均水平
統計數據的分析Stata 14 2軟件用於統計
分析結果：1）HBsAg定量顯著
在S1前陽性組中高於陰性組
組（Z = -15983，P = 0 000）Pre-S1陽性單次試驗
HBsAg <1000COI，1000〜2000COI區間內的比率
2000〜5000COI，> 5000COI有顯著差異（7.28％，
42 53％，71 31％，87 43％，c2 = 317 9634，P = 0 000）類似，
HBV間隔內的單項測試Pre-S1陽性率
DNA水平<10 ^ 3 IU / ml，10 ^ 4〜10 ^ 5 IU / ml和10 ^ 6〜10 ^ 8 IU / ml
ml也有顯著差異（61.34％，74.70％，86.36％，
c2 = 15 7447，P = 0 000）S1之前HBeAg的陽性率
陽性組高於S1陰性前組
（c2 = 20 8575，P = 0 000）2）邏輯倍數的結果
回歸分析表明，單前S1測試陰性
（OR = 1 7），男性（OR = 3 9），持續的S1陰性
在多次隨訪測試中（OR = 6 3），年齡和定量
HBsAg與HCC風險有關4）沒有
Pre-S1與抗HBV藥物治療之間的關聯
轉換（c2 = 4.8954，P = 0.180）。無明顯關聯
被發現在S1之前的狀態或與
結論：S1前陽性反映了肝硬化的危險性。
乙肝病毒和病毒複製的存在，類似於
其他HBV標記包括HBsAg，HBeAg和HBV DNA
目前口服抗HBV藥物對
S1之前的狀態或其血清學改變
通知持續的前S1和HBsAg和/或HBV DNA
陽性反映了HBV清除不暢和S1之前持續
HBsAg陽性陰性與更高
CHB患者的HCC風險。