乙型肝炎病毒基本核心启动子突变定量检测和对慢性乙肝人群的健康管理意义.docVIP

乙型肝炎病毒基本核心启动子突变定量检测和对慢性乙肝人群的健康管理意义 江伟俊1 张圆海2 邢茂迎3 满晓波3 1上海市同仁医院消化内科 上海市 200438 2江苏省镇江市第三人民医院传染科 镇江市212003 3第二军医大学附属东方肝胆外科医院门诊部 上海市 200438 目的：检测未发生肝癌的乙肝病人、发生肝癌的乙肝病人的血清和肝脏组织中乙肝病毒BCP区双突变，探讨检测此突变对于乙肝病人发生肝癌的健康管理和预防指导的意义。方法：采用一种新的基于引物探针特异性的定量PCR方法进行准确的突变检测。结果：克隆了HBV的BCP区1762（A-T）/1764（G-A）双突变相关的野生型质粒、1762单独突变型质粒、1764单独突变型质粒和1762/1764双突变质粒。检测发现未发生肝癌的慢性乙肝病人的血清突变率为50%，肝癌病人突变率为77%，两组比较有统计学差异，p=0.0184。肝癌病人的肝脏组织中突变率为64.70%。结论：发生肝癌的乙肝患者的HBV的BCP区双突变发生率明显高于未发生肝癌的乙肝患者，此突变和乙肝发展为肝癌正相关，检测此突变可以对乙肝患者的健康管理提供指导。 通信作者：满晓波，第二军医大学附属东方肝胆外科医院门诊部 上海市 200438 基金项目：上海市卫生局科研课题《乙肝病毒BCP区双突变对核苷类药物耐药突变影响的临床研究》，编号2008081  Quantitative detection of basic core promoter mutants of Hepatitis B virus in hepatitis B and hepatocellular carcinoma patients Jiang Wei-Jun 1, Zhang Yuan-Hai 2, Xing Mao-Ying 3, Man Xiao-Bo 3 * 1 Department of Gastroenterology, TongRen hospital, Shanghai, 200000 2 Department of Infectious Disease, The Third hospital of Zhenjiang, zhenjiang City, 200000 3 Department of Outpatient, Eastern Hepatobiliary Surgery Hospital, Shanghai, 200438 Corresponding to: Man Xiao-Bo, Department of Outpatient, Eastern Hepatobiliary Surgery Hospital, Shanghai, 200438 Objective: Detection of basic core promoter (BCP) mutants of Hepatitis B virus (HBV) in hepatitis B patients with or without hepatocellular carcinoma. Method: Using a new method of real time PCR based on specific primer. Result: Different BCP mutant plasmids were cloned including of wild type, 1762 mutant, 1764 mutant and 1762/1764 double mutant. BCP mutation was detected in 50% of chronic hepatitis B patients without HCC while in 77% with HCC (p=0.0184). BCP mutation was 65% in liver tissue specimen of HCC patients with HBV infection. Conclusion: BCP mutation was happened significant more in HBV patients with HCC than that in HBV patients without HCC indicating that BCP mutation was correlation with HCC development in HBV patients.  乙型肝炎病毒（hepatitis B