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目的通过对乙型肝炎相关性肝癌(HCC)患者血清低拷贝HBV DNA的检测,探讨乙肝病毒低复制水平与肝癌发生、发展的相关性,明确乙型肝炎患者血清低拷贝HBV DNA检测的临床意义。方法在所有乙型肝炎相关性HCC患者中,选取85例血清HBV DNA水平持续小于1 000 IU/ml的患者,对其病情发生、发展、演变进行系统的回顾分析,同时获得其血清,进行乙型肝炎标志物、肝功能、甲胎蛋白及低拷贝HBV DNA的检测,最后分析各项指标与低拷贝HBV DNA的相关性,分析其临床意义。结果 85例乙型肝炎相关性HCC患者当中,乙型肝炎标志物HBe Ag阳性者有15例,占17.65%,HBe Ag阴性者70例,占82.35%。肝功能指标(ALT及AST)异常者52例,占61.18%。甲胎蛋白(AFP)异常升高者65例,占76.47%。低拷贝HBV DNA水平大于20 IU/ml者72例,占84.71%。低拷贝HBV DNA水平小于20 IU/ml者13例,占15.29%。结论乙型肝炎相关性HCC与乙型肝炎病毒持续复制有关,常规的HBV DNA检测只能检测HBV DNA水平大于1 000 IU/ml的患者,乙肝病毒低复制患者往往会被忽视,导致患者不能及时抗病毒治疗而使得病情发展。因此这种检测已不能满足临床的实际要求,乙型肝炎患者低拷贝HBV DNA检测更有临床指导意义。
Objective To detect the low copy HBV DNA in serum of hepatitis B patients with hepatocellular carcinoma (HCC) and to explore the relationship between the low replication of hepatitis B virus (HBV) and the occurrence and development of hepatocellular carcinoma (HCC). To clarify the clinical significance of low copy HBV DNA detection in patients with hepatitis B . Methods In all patients with hepatitis B-associated HCC, 85 patients with serum HBV DNA level less than 1 000 IU / ml were enrolled in this study. The pathogenesis, development and evolution of hepatitis B virus were systematically reviewed and analyzed. Hepatitis markers, liver function, alpha-fetoprotein and low copy HBV DNA were detected. Finally, the correlation between each index and low copy HBV DNA was analyzed, and its clinical significance was analyzed. Results Of the 85 cases of hepatitis B-related HCC, 15 cases were positive for hepatitis B (HBeAg), accounting for 17.65%, and 70 cases were HBeAg negative (82.35%). Liver function indicators (ALT and AST) were abnormal in 52 cases, accounting for 61.18%. 65 cases of abnormal increase of AFP, accounting for 76.47%. Low copy HBV DNA levels greater than 20 IU / ml in 72 cases, accounting for 84.71%. Low copy HBV DNA levels less than 20 IU / ml in 13 cases, accounting for 15.29%. Conclusions Hepatitis B-associated HCC is associated with sustained replication of hepatitis B virus. Conventional HBV DNA testing can only detect patients with HBV DNA levels greater than 1 000 IU / ml. Hepatitis B virus low-copy patients are often overlooked, leading to inability of patients to respond promptly Antiviral therapy that makes the disease progress. Therefore, this test has failed to meet the actual clinical requirements, hepatitis B patients with low copy HBV DNA testing more clinical significance.