慢性乙型肝炎和肝硬化及肝癌与HLA-DQA1基因多态性关系的研究.DOCVIP

临床医学论文-慢性乙型肝炎和肝硬化及肝癌与HLA-DQA1基因多态性关系的研究 ?????????????? 作者：刘春涛　程宝泉　张宗利? 【摘要】? 　　目的：研究 HLA-DQA1 等位基因多态性与慢性乙型肝炎（HBV）病毒感染、肝硬化及肝癌的关系。方法：采用聚合酶链序列特异性引物（PCR-SSP）技术分别对 168 例慢性 HBV 感染者（包括 48 例慢性乙型肝炎、42 例乙型肝炎肝硬化和 78 例乙型肝炎后肝癌患者）以及 100 例对照（感染后自发恢复者）进行 HLA-DQA1 等位基因的检测。结果：慢性HBV感染者 HLA-DQA1*0102 的表型频率显著低于对照组（25.6% vs 47.0%, OR = 0.39，Pc=0.003 ），DQA1*0601表型频率高于对照组（4.2% vs 0, OR=0.96, P=0.039），但后者差异无统计学意义（Pc＞0.05）。肝硬化患者 DQA1*0104 的表型频率显著低于无肝硬化患者（6.4% vs 28.4%, OR=0.17, Pc=0.001），DQA1*0201 的表型频率高于无肝硬化患者（27.7% vs 12.2%, OR=2.76, P=0.014），但后者差异无统计学意义（Pc＞0.05）。HLA-DQA1 各等位基因的表型频率在肝癌患者与非肝癌患者间差异无统计学意义。结论：HLA-DQA1*0102 等位基因可能降低慢性HBV 感染的风险，而 DQA1*0104 等位基因可能降低乙型肝炎肝硬化的风险。乙型肝炎后肝癌的发生与HLA-DQA1 等位基因无明显相关性。 【关键词】? 肝炎，乙型·肝肿瘤·HLA抗原 　　 Association of HLA-DQA1 allele and chronic hepatitis B, liver cirrhosis and hepatocellular carcinoma ????? 【ABSTRACT】 Objective: To investigate the association of HLA-DQA1 allele, chronic HBV infection, liver cirrhosis （LC）, and hepatocellular carcinoma （HCC）. Methods: The patients of 168 ??? chronic HBV infection （including 48 chronic hepatitis B, 42 LC and 78 HCC patients） and 100 controls who had recovered from HBV infection were investigated for HLA-DQA1 typing by PCR/ SSP technique. Results: In chronic HBV infection patients, the phenotype frequency of DQA1*0102 was significantly decreased （25.6% vs 47.0%, OR = 0.39, Pc=0.003）, while DQA1*0601 was significantly increased （4.2% vs 0.0%, OR=0.96, P=0.039） compared with controls. The frequency of DQA1*0104 was significantly decreased （6.4% vs 28.4%, OR=0.17, Pc=0.001）, while DQA1*0201 was significantly increased （27.7% vs 12.2%, P = 0.014, OR = 2.76） in chronic HBV infection patients with LC compared to those without LC. But the differences of DQA1*0601 and DQA1*0201 failed to be significant after Bonferroni correction （Pc0.05）. There was no significant difference in DQA1 alleles between chronic HBV infection patients with or without HCC （P0.05）. Conclusion: HLA-DQA1*0102 and DQA1*0104 were associated with protect