乙肝肝硬化癌变患者血清AFP-L3及HBV DNA的变化及其可能的临床意义-东南大学学报医学版

乙肝肝硬化癌变患者血清AFP-L3及HBV DNA的变化及其可能的临床意义

单位：1. 遵义市第一人民医院肝胆外科, 贵州遵义 563000;
2. 遵义医学院第一附属医院病理科, 贵州遵义 563000

分类号：R735.7

出版年·卷·期（页码）：2019·38·第三期（481-485）

摘要：

目的：分析乙型肝炎（简称乙肝）肝硬化癌变患者血清甲胎蛋白异质体L3（AFP-L3）及乙肝病毒DNA（HBV DNA）的变化特征，并探讨其可能的临床意义。方法：选取遵义市第一人民医院2015年1月至2017年12月收治的81例乙肝肝硬化患者，分为癌变组和非癌变组，检测两组患者血清AFP-L3及HBV DNA表达。根据肝功能Child-Pugh改良分级的不同将患者分为A、B、C 3个亚组，比较3个亚组患者的血清AFP-L3、HBV DNA表达水平，并分析乙肝肝硬化癌变患者Child-Pugh分级与血清AFP-L3、HBV DNA的相关性。结果：癌变组患者血清AFP-L3水平明显高于非癌变组患者（P<0.05）。血清AFP-L3、HBV DNA水平C亚组明显高于A、B亚组（P<0.05），B亚组明显高于A亚组（P<0.05）。乙肝肝硬化癌变患者肝功能Child-Pugh分级与血清AFP-L3、HBV DNA表达水平呈正相关（P<0.05）。结论：乙肝肝硬化患者发生癌变后，血清AFP-L3和HBV DNA表达均明显升高，两者可作为乙肝肝硬化癌变的辅助诊断指标。

Objective:To analyze the changes of serum alpha-fetoprotein heterogeneous L3(AFP-L3) and hepatitis B virus DNA(HBV DNA) in patients with hepatitis B liver cirrhosis and to discuss their possible clinical significance. Methods:Eighty-one patients with hepatitis B liver cirrhosis admitted to the Zunyi First People's Hospital from January 2015 to December 2017 were selected in this study. The patients were divided into cancerous group and non-cancerous group. The levels of serum AFP-L3 and HB DNA in the two groups were detected. All the patients were divided into A, B and C subgroups according to Child-Pugh liver function classifications. The serum levels of AFP-L3 and HB DNA in the three subgroups were compared. The correlation between Child-Pugh classification of liver function and the levels of serum AFP-L3 and HB DNA was analyzed by Pearson correlation. Results:The levels of serum AFP-L3 and HB DNA in the cancerous group were significantly higher than those in the non-cancerous group(P<0.05). The serum AFP-L3 and HB DNA levels in subgroup C patients in the cancerous group were significantly higher than those in subgroup B and A(P<0.05). The serum levels of AFP-L3 and HB DNA in subgroup B were significantly higher than those in subgroup A(P<0.05). Pearson correlation analysis showed that the Child-Pugh classification of liver function in patients with hepatocarcinogenesis was positively correlated with serum AFP-L3 and HB DNA expression levels(P<0.05). Conclusion:The levels of serum AFP-L3 and HB DNA in patients with cirrhosis after carcinogenesis are increased significantly, which suggests that AFP-L3 and HB DNA may be used as auxiliary diagnostic markers for hepatocarcinogenesis in patients with liver cirrhosis.

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