【摘要】 目的探讨海府地区慢性HBV感染者病毒学特征与P16mRNA改变的相互关系。方法选取2013年1月至2015年12月期间海口市人民医院住院治疗的200例慢性HBV感染者作为研究对象,依照HBV感染自然史分为慢性无症状HBV携带组、HBe Ag(+)慢性乙型肝炎组、非活动性HBs Ag携带组和HBe Ag(-)慢性乙型肝炎组,各50例。PCR-RELP法检测HBV基因型和PC/BCP变异,RT-PCR检测P16mRNA。比较各个慢性HBV感染不同免疫状态组HBV基因型的分布情况;比较各个慢性HBV感染不同免疫状态组HBV变异类型的比率;比较各个慢性HBV感染不同免疫状态组的P16mRNA表达缺失率;对BCP变异比率与P16mRNA表达缺失率进行相关性分析。结果 (1)各个慢性HBV感染不同免疫状态组HBV基因型的分布情况均以B型为主(P>0.05),无统计学意义。(2)随着慢性HBV感染自然史的进展,BCP变异的比率却逐渐增高(30.00%vs61.65%vs76.47%vs89.47%)(P<0.05),差异具有统计学意义。⑶随着慢性HBV感染自然史的进展,各个慢性HBV感染不同免疫状态组P16mRNA的表达缺失率逐步增高(2.00%vs14.00%vs26.00%vs34.00%)(P<0.05),差异具有统计学意义。(4)Person相关性分析显示,BCP变异比率与P16mRNA表达缺失率呈正相关(r=0.826,P<0.05)。结论海府地区慢性HBV感染进程的4个阶段(免疫耐受期、免疫清除期、免疫不全期和再活动期)均以B型基因为主,但是随着慢性HBV感染自然史的进展,BCP变异比率和P16mRNA表达缺失率均逐渐增高,表明BCP变异和P16基因的改变可能是肝细胞癌进程中的重要事件。更多还原

【Abstract】 Objective To investigate the relationships between virological characteristics and changes of P16 mRNA in patients with chronic HBV infection in Hainan area. Methods 200 patients with chronic HBV infection who were hospitalized in Haikou People’ s Hospital from January 2013 to December 2015 were selected as the subjects. According to the natural history of HBV infection,the patients were divided into chronic asymptomatic HBV carrying group,HBe Ag( +) chronic hepatitis B Hepatitis group,inactive Hbs Ag carrying group and Be Ag(-) chronic hepatitis B group,50 cases each. HBV genotype and PC/BCP mutation were detected by PCR-RFLP. P16 mRNA was detected by RT-PCR. The distribution of HBV genotypes in different immunized states of chronic HBV infection were compared. The rates of HBV variants in the different immune status groups of each chronic HBV infection were compared. The expression of P16 mRNA in different immunized groups with chronic HBV infection were also compared. The correlation between BCP mutation rate and P16 mRNA expression deletion rate was analyzed. Results( 1) The distribution of HBV genotype in different immunized states of chronic HBV infection was mainly B type( P > 0. 05),which was not statistically significant.( 2) The rate of BCP mutation was gradually increased with the progress of natural history of chronic HBV infection( 30. 00% vs61. 65% vs 76. 47% vs 89. 47%)( P < 0. 05),which was statistically significant.( 3) With the progression of natural history of chronic HBV infection,the expression of P16 mRNA in different immunized HBV groups was gradually increased( 2. 00% vs14. 00% vs26. 00% vs 34. 00%)( P < 0. 05),which was statistically significant.( 4) Pearson correlation analysis showed that BCP mutation rate was positively correlated with P16 mRNA expression loss rate( r = 0. 826,P < 0. 05).Conclusion The four stages of chronic HBV infection in Hainan area( immune tolerance period,immune clearance period,immunological inexplasia and recurrence period) are predominantly B-type genes,but with the progress of natural history of chronic HBV infection,BCP Mutation rate and P16 mRNA expression loss rate was gradually increased,indicating that BCP mutation and P16 gene changes might be important in the process of hepatocellular carcinoma.更多还原