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標題: | 隱性B型肝炎病毒感染和肝細胞癌的罹病及預後的關係 Role of Occult Hepatitis B Virus Infection in the Etiology and Prognosis of Hepatocellular Carcinoma |
作者: | Chuo-Shih Chen 陳卓士 |
指導教授: | 于明暉(Ming-Whei Yu) |
關鍵字: | B型肝炎隱性感染,肝細胞癌,C型肝炎病毒,酒精攝取,腫瘤大小,甲型胎兒蛋白, occult HBV,HCC,HCV,alcohol,tumor size,AFP, |
出版年 : | 2010 |
學位: | 碩士 |
摘要: | 研究背景和目的
B型肝炎隱性感染可能會導致肝細胞癌發生。本研究針對肝細胞癌進行病例系列研究,探討:1) B型肝炎隱性感染在non-B病例中的盛行率;2)B型肝炎隱性感染病例之特徵及和病因的關係;3) B型肝炎隱性感染和臨床表徵及存活的關係。 材料與方法 研究個案包括420名HBsAg陰性的肝細胞癌病例,依照anti-HCV狀態、酒精攝取,將研究個案區分成不同病因組。採用nested-PCR方法檢測HBV surface (S)及X基因區病毒DNA。 結果 HBV DNA 在S、X、及S且X區陽性率,各為21.4%、11.0%、和15.2%。anti-HCV陽性者與陰性者相比,其B型肝炎隱性感染率顯著偏低(P=0.01),男性之隱性感染率高於女性(P=0.0374)。進入醫院時的血清α-fetoprotein(AFP)、腫瘤大小和B型肝炎隱性感染呈現正相關。但在控制其他危險因子及進入醫院之臨床特徵之後,並未發現HBV DNA陽性和存活有關。 結論 non-B、non-C病例及男性有較高的B型肝炎隱性感染率,且B型肝炎隱性感染和較高的AFP及較大的腫瘤有關。 Background & Aims: Occult hepatitis B virus (HBV) infection has been implicated in the etiology of hepatocellular carcinoma (HCC). The specific aims of this study were to 1) estimate the prevalence of occult HBV infection in major etiological groups of HCC patients, 2) identify factors associated with occult HBV infection in HCC patients, and 3) assess the association of occult HBV infection with clinical features at hospital admission and survival. Methods: Study subjects included 420 hepatitis B surface antigen-negative HCC patients. They were grouped into different classes according to the status of antibodies against hepatitis C virus (anti-HCV) and the intensity and duration of alcohol consumption. We detected HBV DNA in circulation by a nested-polymerase chain reaction with primers designed based on the sequences of the surface(S) and X regions of HBV. Results: Overall, 90 (21.4%) patients were positive for HBs DNA, 46 (11.0%) tested positive for HBx DNA, and 64 (15.2%) tested positive for both HBs DNA and HBx DNA. While anti-HCV positive patients had a lower prevalence of occult HBV infection than anti-HCV negative patients (P=0.01), males had a higher prevalence than females (P=0.0374). Serum α-fetoprotein levels and tumor size were positively correlated with occult HBV infection. However, we failed to detect a significant association between occult HBV infection and survival after adjustment for potential prognostic factors. Conclusions: Occult HBV infection was more frequently detected in non-B, non-C HCC patients than in HBsAg-negative, anti-HCV-positive patients with HCC, and was more prevalent in male HCC patients than in female HCC patients. This infection may be associated with a more severe stage of HCC. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/22475 |
全文授權: | 未授權 |
顯示於系所單位: | 流行病學與預防醫學研究所 |
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