【作者】 李娜；

【导师】 赵彩彦；

【作者基本信息】 河北医科大学 ， 内科学（专业学位）， 2019， 硕士

【摘要】 目的:众所周知,乙型肝炎病毒(hepatitis B virus,HBV)感染与肝细胞性肝癌(hepatocellular carcinoma,HCC)的发生发展密切相关。近年来,越来越多研究发现,HBV感染与肝细胞癌以外的其他恶性肿瘤相关,其中包括非霍奇金淋巴瘤(NHL)、胰腺癌、胆管细胞癌等。研究表明,乙肝表面抗原阳性的患者B细胞非霍奇金淋巴瘤(B-NHL)的发病风险显著增高,而接受化疗药物治疗的淋巴瘤患者,则面临HBV再激活的可能,具有发生HBV相关肝功能衰竭的风险。因此,HBV作为潜在致病因素,在NHL发生发展中所发挥的作用是目前临床上极为关注的话题。本文通过分析3例HBs Ag阳性的NHL病例的临床症状、诊断结果及治疗过程,深入探讨HBV在NHL发病机制中的作用,并对NHL治疗过程中HBV再激活提出应对策略。方法:选取3例就诊于河北医科大学第三医院的HBs Ag阳性的NHL的患者的临床病例资料,归纳总结HBs Ag阳性NHL患者的临床特点及治疗方案,同时查阅国内外相关文献,探讨HBV在NHL发病机制中的作用,并对NHL治疗过程中HBV再激活提出应对策略。结果:本文所选取的3例病例中,HBV感染病史较长,首发症状各不相同,但病理结果均证实为非霍奇金淋巴瘤。结论:HBV感染机体后,通过激活NF-κB通路、Wnt/β-catenin信号通路、激活原癌基因等途径参与非霍奇金淋巴瘤的形成。更多还原

【Abstract】 Objective: It is well known that hepatitis B virus(HBV)infection is closely related to the occurrence and development of hepatocellular carcinoma(HCC).In recent years,more and more studies have found that HBV infection is associated with other malignant tumors other than hepatocellular carcinoma,including non-Hodgkin’s lymphoma(NHL),pancreatic cancer,and cholangiocarcinoma.Hepatitis B surface antigen-positive patients have a significantly increased risk of developing B-cell non-Hodgkin’s lymphoma(B-NHL),while lymphoma patients treated with chemotherapy drugs are at risk of HBV reactivation and HBV-related liver failure.Therefore,the role of HBV as a potential pathogenic factor in the development of NHL is currently a topic of great concern in clinical practice.In this paper,we analyzed the clinical symptoms,diagnosis and treatment of 3 cases of HBs Ag-positive NHL cases,and further explored the role of HBV in the pathogenesis of NHL,and proposed strategy for HBV reactivation during NHL treatment.Method: We select the clinical data of 3 patients with HBs Ag-positive NHL who were admitted to the Third Hospital of Hebei Medical University,to summarize the clinical features and treatment options of HBs Ag-positive NHL patients,to consult relevant literature at home and abroad,to explore the role of HBV in the pathogenesis of NHL,and to propose a coping strategy for HBV reactivation during NHL treatment.Conclusion: Among the 3 cases selected in this article,the history of HBV infection was longer and the initial symptoms were different,but the pathological results were confirmed to be non-Hodgkin’s lymphoma.更多还原