C型HBV是导致HCC的独立危险因素

zasxz

Infection with Genotype C Hepatitis B Virus Is an Independent Risk Factor for Development of Hepatocellular Carcinoma The identification of risk factors for the development of hepatocellular carcinoma (HCC) is important for HCC surveillance in chronic hepatitis B virus (HBV) infection. The primary aim of the current study was to evaluate the independent risk factors and effect of HBV genotypes on HCC development in a prospective longitudinal cohort of chronic hepatitis B patients. Chronic hepatitis B patients recruited since 1997 were prospectively followed up for the development of HCC. HCC was diagnosed by a combination of alpha fetoprotein, imaging, and histology. Liver cirrhosis was defined as ultrasonic features of cirrhosis together with hypersplenism, ascites, varices, and/or encephalopathy. Results In total, 426 patients were followed up for 1664 person years; median 225 weeks. Forty-nine (11%) patients had underlying clinical liver cirrhosis. A total of 242 (57%) and 179 (42%) patients had HBV genotypes C and B, respectively. Twenty-five patients developed HCC in a median follow up of 121 (range 14-236) weeks. The overall incidence of HCC was 1502 cases per 100 000 person years. On multivariate analysis, clinical liver cirrhosis and HBV genotype C infection were independently associated with HCC development, with an adjusted relative risk of 10 (p<0.001) and 2.84 (p = 0.040), respectively. Patient age, sex, hepatitis B e antigen (HBeAg) status, alanine aminotransferase (ALT) levels, and basal core promoter mutations did not predict HCC development. Patients infected with HBV genotype C tended to have persistently positive HBeAg or fluctuating HBeAg status and higher ALT levels during the follow up period. Conclusion Genotype C HBV infection is an independent risk factor for HCC development in addition to liver cirrhosis. Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, China. 09/29/04 Reference H L Chan and others. Genotype C hepatitis B virus infection is associated with an increased risk of hepatocellular carcinoma. Gut 53(10): 1494-1498. October 2004.

特深沉

C型HBV是导致HCC的独立危险因素 Infection with Genotype C Hepatitis B Virus Is an Independent Risk Factor for Development of Hepatocellular Carcinoma The identification of risk factors for the development of hepatocellular carcinoma (HCC) is important for HCC surveillance in chronic hepatitis B virus (HBV) infection. 辨别发生肝癌的危险因素，对慢性HBV感染者非常重要。 The primary aim of the current study was to evaluate the independent risk factors and effect of HBV genotypes on HCC development in a prospective longitudinal cohort of chronic hepatitis B patients. 目前的研究的基本目的是评估HBV基因型对发生肝癌的影响和独立危险因素，不同年龄段慢性HBV的预期。 Chronic hepatitis B patients recruited since 1997 were prospectively followed up for the development of HCC. 慢性HBV患者，从1977年开始跟踪，预期以后肝癌发生的情况。 HCC was diagnosed by a combination of alpha fetoprotein, imaging, and histology. Liver cirrhosis was defined as ultrasonic features of cirrhosis together with hypersplenism, ascites, varices, and/or encephalopathy. 肝癌经由α甲胎蛋白，成像，组织学方法检测。肝硬化由超声特征和脾功能亢进，腹水，静脉 曲张，以及肝性脑病来定义。 Results In total, 426 patients were followed up for 1664 person years; median 225 weeks. Forty-nine (11%) patients had underlying clinical liver cirrhosis. A total of 242 (57%) and 179 (42%) patients had HBV genotypes C and B, respectively. 总共有426名患者跟踪了1664人年；平均225周。总共有242名（57%）和179名（42）患者分别是HBV基因C型和B型。 49名（11%）患者有慢性肝硬化。 Twenty-five patients developed HCC in a median follow up of 121 (range 14-236) weeks. 25%的患者在平均跟踪121周（从14周到236周）发生肝癌。 The overall incidence of HCC was 1502 cases per 100 000 person years. 总体上，每年万人中有1502例肝癌发生。 On multivariate analysis, clinical liver cirrhosis and HBV genotype C infection were independently associated with HCC development, with an adjusted relative risk of 10 (p<0.001) and 2.84 (p = 0.040), respectively. 综合分析，临床肝硬化和HBV基因C型感染独立地和肝癌发生相关联，调整后的危险相关性分别是10 (p<0.001) and 2.84 (p = 0.040) Patient age, sex, hepatitis B e antigen (HBeAg) status, alanine aminotransferase (ALT) levels, and basal core promoter mutations did not predict HCC development. 患者的年龄，性别，乙肝核心抗原 (HBeAg)状态，ALT水平，内核变异，不能预测肝癌的发生。 Patients infected with HBV genotype C tended to have persistently positive HBeAg or fluctuating HBeAg status and higher ALT levels during the follow up period. 患者感染HBV基因型C型倾向持于HBeAg持久阳性，或HbeAg摇摆变动，ALT水平高（在跟踪期间） Conclusion Genotype C HBV infection is an independent risk factor for HCC development in addition to liver cirrhosis. 结论：基因型是C型的HBV感染者，以及肝硬化，是肝癌发生的独立因素， Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, China. 中国香港 09/29/04 Reference H L Chan and others. Genotype C hepatitis B virus infection is associated with an increased risk of hepatocellular carcinoma. Gut 53(10): 1494-1498. October 2004.

lj

高深，能否解释一下

特深沉

1.患者的年龄，性别，乙肝核心抗原 (HBeAg)状态，ALT水平，内核变异，不能预测肝癌的发生。

2.结论：基因型是C型的HBV感染者，以及肝硬化，是肝癌发生的独立因素，

zasxz

谢谢特深沉兄

健康多好919

何为基因C型HBV的感染者？

特深沉

以下是引用健康多好919在2004-10-5 17:03:02的发言：
何为基因C型HBV的感染者？

回答出来，就是诺贝尔奖。

特深沉

look

乙肝杀手

乙肝病毒有很多基因型，有种说法是8种，常见的有ABCD四型，国内主要是BC两型，有学者认为b型南方多见，c型北方多见，c型容易慢性化，易导致肝硬化、肝癌的发生，且对干扰素效果不佳。

基因型的测定，目前医院没有常规开展检查，但临床研究中应用常见。

[此贴子已经被作者于2005-6-3 18:54:46编辑过]