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预防医学  2025, Vol. 37 Issue (10): 1024-1028    DOI: 10.19485/j.cnki.issn2096-5087.2025.10.010
  肿瘤流行病学专题 本期目录 | 过刊浏览 | 高级检索 |
原发性肝癌患者乙型肝炎病毒血清标志物和肝功能指标分析
彭丽君, 龚莉, 季沈杰, 薛学锋, 陈建国
南通大学附属启东医院,启东市人民医院,启东肝癌防治研究所,江苏 启东 226200
Hepatitis B virus serological marker and liver function index among patients with primary liver cancer
PENG Lijun, GONG Li, JI Shenjie, XUE Xuefeng, CHEN Jianguo
The Affiliated Qidong Hospital of Nantong University, Qidong People's Hospital, Qidong Liver Cancer Institute, Qidong, Jiangsu 226200, China
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摘要 目的 了解原发性肝癌(PLC)患者不同乙型肝炎病毒血清标志物(HBVM)肝功能指标异常率,为PLC患者风险分层与诊疗方案优化提供参考。方法 选择2017年1月—2024年6月启东市人民医院确诊的PLC患者为研究对象,通过医院信息管理系统收集性别、年龄等基本资料;采集静脉血,检测HBsAg、抗HBs、HBeAg、抗HBe、抗HBc 5项HBVM和丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、胆碱酯酶(CHE)、腺苷脱氨酶(ADA)等10项肝功能指标。比较大三阳、小三阳、三抗体阳性、s/c抗体阳性、e/c抗体阳性和全阴性6种HBVM组合的肝功能指标异常率。结果 纳入1 434例PLC患者,其中男性1 043例,占72.73%;女性391例,占27.27%。年龄MQR)为64.00(16.00)岁。HBsAg、抗HBs、HBeAg、抗HBe和抗HBc阳性率分别为51.95%、29.43%、10.81%、60.32%和88.42%。大三阳、小三阳、三抗体阳性、s/c抗体阳性、e/c抗体阳性和全阴性分别为85、491、170、148、100和121例,占5.93%、34.24%、11.85%、10.32%、6.97%和8.44%。6种HBVM组合PLC患者ALT异常率分别为26.19%、28.33%、13.94%、22.60%、20.41%和14.91%,AST异常率分别为33.33%、36.17%、23.03%、24.66%、22.45%和18.42%,LDH异常率分别为62.16%、68.22%、53.73%、61.19%、60.00%和68.42%,CHE异常率分别为0%、1.81%、0%、2.11%、2.22%和3.88%,ADA异常率分别为59.09%、57.27%、24.27%、33.33%、45.00%和37.04%,差异有统计学意义(均P<0.05)。结论 本研究PLC患者HBVM组合以小三阳为主,6种HBVM组合中肝功能指标异常率的显著差异可反映PLC患者肝损伤状况。
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彭丽君
龚莉
季沈杰
薛学锋
陈建国
关键词 原发性肝癌乙型肝炎病毒血清标志物肝功能指标    
AbstractObjective To analyze the hepatitis B virus serological markers (HBVM) and abnormal rates of liver function indexes among primary liver cancer (PLC) patients with different HBVM profiles, so as to provide a reference for risk stratification and optimization of diagnosis and treatment strategies for PLC patients. Methods Patients diagnosed with PLC at Qidong People's Hospital between January 2017 and June 2024 were selected for this study. Basic information such as gender and age was collected through the hospital information management system. Venous blood samples were drawn to test for HBsAg, anti-HBs, HBeAg, anti-HBe, and anti-HBc, as well as ten liver function indexes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), cholinesterase (CHE), and adenosine deaminase (ADA). Compare the abnormal rates of liver function indexes among the six HBVM profiles: "big three yang" (HBsAg+, HBeAg+, anti-HBc+), "small three yang" (HBsAg+, anti-HBe+, anti-HBc+), triple antibody positive (anti-HBs+, anti-HBe+, anti-HBc+), s/c antibody positive (anti-HBs+, anti-HBc+), e/c antibody positive (anti-HBe+, anti-HBc+), and all negative. Results A total of 1 434 patients with PLC were enrolled in this study. Among them, 1 043 (72.73%) were males and 391 (27.27%) were females. The median age was 64.00 (interquartile range, 16.00) years. The positive rates for HBsAg, anti-HBs, HBeAg, anti-HBe, and anti-HBc were 51.95%, 29.43%, 10.81%, 60.32%, and 88.42%, respectively. The "big three yang", "small three yang", triple-antibody positive, s/c antibody positive, e/c antibody positive, and all-negative profiles accounted for 85 (5.93%), 491 (34.24%), 170 (11.85%), 148 (10.32%), 100 (6.97%), and 121 (8.44%) cases, respectively. The abnormal rates of ALT among PLC patients with six HBVM profiles were 26.19%, 28.33%, 13.94%, 22.60%, 20.41%, and 14.91%, respectively. The abnormal rates of AST were 33.33%, 36.17%, 23.03%, 24.66%, 22.45%, and 18.42%, respectively. The abnormal rates of LDH were 62.16%, 68.22%, 53.73%, 61.19%, 60.00%, and 68.42%, respectively. The abnormal rates of CHE were 0%, 1.81%, 0%, 2.11%, 2.22%, and 3.88%, respectively. The abnormal rates of ADA were 59.09%, 57.27%, 24.27%, 33.33%, 45.00%, and 37.04%, respectively. These differences were statistically significant (all P<0.05). Conclusions In this study, the HBVM profiles were mainly characterized by "small triple positive" among PLC patients. The significant differences in liver function indexes abnormal rates among PLC patients with six HBVM profiles could reflect the liver injury status.
Key wordsprimary liver cancer    hepatitis B virus serological marker    liver function index
收稿日期: 2025-06-30      修回日期: 2025-09-02     
中图分类号:  R373.2  
  R446.62  
基金资助:国家重点研发计划项目(2021YFC2500405); 南通市科技局项目(JCZ2022033)
作者简介: 彭丽君,本科,副主任技师,主要从事流式细胞和血液实验室诊断工作
通信作者: 薛学锋,E-mail:qdxxf1105@sina.cn   
引用本文:   
彭丽君, 龚莉, 季沈杰, 薛学锋, 陈建国. 原发性肝癌患者乙型肝炎病毒血清标志物和肝功能指标分析[J]. 预防医学, 2025, 37(10): 1024-1028.
PENG Lijun, GONG Li, JI Shenjie, XUE Xuefeng, CHEN Jianguo. Hepatitis B virus serological marker and liver function index among patients with primary liver cancer. Preventive Medicine, 2025, 37(10): 1024-1028.
链接本文:  
http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2025.10.010      或      http://www.zjyfyxzz.com/CN/Y2025/V37/I10/1024
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