【摘要】 目的 研究错配修复基因（MMR）在乙型肝炎病毒（HBV）相关肝细胞癌中表达的影响因素。方法 回顾性分析2019年12月至2021年6月首都医科大学附属北京佑安医院收治的125例HBV相关肝细胞癌术后MMR免疫组织化学结果，将其分为MMR缺失（dMMR）组（18例）和MMR正常（pMMR）组（107例），比较两组病理特征和临床指标，进一步分析HBV相关肝细胞癌患者发生dMMR的影响因素。结果 dMMR组缺失情况包括MutL蛋白同系物1(MLH1)/减数分裂后分离蛋白2(PMS2)表达缺失（4例）、MLH1表达缺失（1例）、Mut S蛋白同系物2(MSH2)/PMS2表达缺失（1例）、PMS2表达缺失（12例）。dMMR组坏死率、微血管侵犯率、谷草转氨酶水平、异常凝血酶原水平低于pMMR组，差异有统计学意义（P <0.05）。两组分化程度、Edmondson分级、P53蛋白强度比较，差异有统计学意义（P <0.05）。多因素分析结果显示，Edmondson分级、谷草转氨酶水平是发生dMMR的独立影响因素（P <0.05）。结论 dMMR在HBV相关肝细胞癌中是一种低频事件，与患者Edmondson分级、谷草转氨酶水平有关，可能是治疗疾病的一种有效的靶标。更多还原

【Abstract】 Objective To investigate the influencing factors of mismatch repair gene(MMR) expression in hepatitis B virus(HBV)-associated hepatocellular carcinoma. Methods The MMR immunohistochemical results of 125 patients with HBV-associated hepatocellular carcinoma admitted to Beijing Youan Hospital, Capital Medical University from December2019 to June 2021 were retrospectively analyzed. The patients were divided into deficiency MMR(dMMR) group(18 cases)and proficiency MMR(p MMR) group(107 cases). The influencing factors of dMMR in patients with HBV-associated hepatocellular carcinoma were further analyzed. Results The deletion of dMMR group included the loss of Mut L homologue1(MLH1)/postmeiotic protein isolate 2(PMS2) expression(4 cases), the loss of MLH1 expression(1 case), the loss of MutS protein homologue 2(MSH2)/PMS2 expression(1 case), and the loss of PMS2 expression(12 cases). The necrosis rate,microvascular invasion rate, glutamic-oxaloacetic transaminase level, and abnormal prothrombin level in dMMR group were lower than those in pMMR group, and the differences were statistically significant(P < 0.05). There were significant differences in differentiation degree, Edmondson grade, and P53 protein intensity between the two groups(P < 0.05). The results of multivariate analysis showed that Edmondson grade and glutamic-oxaloacetic transaminase level were independent influencing factors of d MMR(P < 0.05).Conclusion d MMR is a low-frequency event in HBV-associated hepatocellular carcinoma, which is related to Edmondson grade and glutamic-oxaloacetic transaminase level, and may be an effective target for the treatment of the disease.更多还原