CAJ | 학술논문

目的探讨B细胞型非霍奇金淋巴瘤( NHL)与乙型肝炎病毒(HBV)之间的关系.方法统计2003年1月至2009年12月住院的284例B细胞型NHL患者的乙肝5项标志物阳性率,并与同期住院的大肠癌患者作比较.结果 B细胞型NHL以18～ 39岁和Ⅲ～Ⅳ期患者乙型肝炎表面抗原( HBsAg)阳性率较高,分别为42.6％(26/61)和37.0％(50/135),分别与其他年龄段及Ⅰ～Ⅱ期患者比较,差异均有统计学意义(x2值分别为7.573和6.874,P值分别为0.023和0.009)；B细胞型NHL患者HBsAg、乙型肝炎e抗原(HBeAg)的阳性率较大肠癌患者高[29.6％(84/284)比14.5％( 155/1070),6.7 ％(19/284)比0.8 ％(9/1070),Wald值分别为25.174和20.496,P值均为0.001];乙型肝炎表面抗体(抗HBsAb)阳性率较大肠癌患者低[45.4％(129/284)比58.0％(621/1070),Wald=11.062,P=0.001]; HBsAg、HBeAg及乙型肝炎核心抗体(抗HBcAb)同时阳性和HBsAg、乙型肝炎e抗体(抗HBeAb)及抗HBcAb同时阳性的发生率较大肠癌患者高[6.0 ％(17/284)比0.8％(9/1070),16.2％(46/284)比11.5％(123/1070),x2值分别为31.619和4.542,P值分别为0.000和0.033];抗HBcAb阳性且抗HBsAb阴性的发生率也较大肠癌患者高[37.0％(105/284)比24.5％( 262/1070),Wald=17.708,P＜0.001]；抗HBcAb和抗HBsAb同时阳性的发生率较大肠癌患者低[20.8％(59/284)比27.8％(297/1070),Wald=5.646,P=0.017].结论 HBV感染和B细胞型NHL存在一定相关性,HBV感染可能在B细胞型NHL的病原学中起作用.
목적 탐토B세포형비곽기금림파류( NHL)여을형간염병독(HBV)지간적관계.방법 통계2003년1월지2009년12월주원적284례B세포형NHL환자적을간5항표지물양성솔,병여동기주원적대장암환자작비교.결과 B세포형NHL이18～ 39세화Ⅲ～Ⅳ기환자을형간염표면항원( HBsAg)양성솔교고,분별위42.6％(26/61)화37.0％(50/135),분별여기타년령단급Ⅰ～Ⅱ기환자비교,차이균유통계학의의(x2치분별위7.573화6.874,P치분별위0.023화0.009)；B세포형NHL환자HBsAg、을형간염e항원(HBeAg)적양성솔교대장암환자고[29.6％(84/284)비14.5％( 155/1070),6.7 ％(19/284)비0.8 ％(9/1070),Wald치분별위25.174화20.496,P치균위0.001];을형간염표면항체(항HBsAb)양성솔교대장암환자저[45.4％(129/284)비58.0％(621/1070),Wald=11.062,P=0.001]; HBsAg、HBeAg급을형간염핵심항체(항HBcAb)동시양성화HBsAg、을형간염e항체(항HBeAb)급항HBcAb동시양성적발생솔교대장암환자고[6.0 ％(17/284)비0.8％(9/1070),16.2％(46/284)비11.5％(123/1070),x2치분별위31.619화4.542,P치분별위0.000화0.033];항HBcAb양성차항HBsAb음성적발생솔야교대장암환자고[37.0％(105/284)비24.5％( 262/1070),Wald=17.708,P＜0.001]；항HBcAb화항HBsAb동시양성적발생솔교대장암환자저[20.8％(59/284)비27.8％(297/1070),Wald=5.646,P=0.017].결론 HBV감염화B세포형NHL존재일정상관성,HBV감염가능재B세포형NHL적병원학중기작용.
Objective To evaluate the association between B-cell non-Hodgkin lymphoma (NHL) and hepatitis B virus (HBV).Methods The positive rates of HBV markers in 284 patients of B-cell NHL who were admitted to our department between January 2003 and December 2009 were investigated.The positive rates of HBV markers in colorectal cancer patients were used as controls.Results The HBsAg-positive rates of patients aged 18～ 39 and stage m/Ⅳ patients were 42.6 ％ (26/61) and 37.0 ％ (50/135),which was higher than other groups.The x2 value and P value were 7.573 and 6.874,0.023 and 0.009,respectively.Compared with the control group, the B-cell NHL had significantly higher prevalence of positive HBsAg and positive HBeAg (29.6 ％ vs 14.5 ％,6.7 ％ vs 0.8 ％ ).The Wald values were 25.174 and 20.496,respectively.Both of the P value were ＜0.001 and lower prevalence of positive anti-HBs (45.4 ％ vs 58.0 ％,Wald =11.062,P =0.001).The coexpression of HBsAg, HBeAg and anti-HBc was higher in the B-NHL group than in the control group (6.0 ％ vs 0.8 ％,x2 =31.619,P ＜0.001).Similarly,the coexpression of HBsAg,anti-HBe,and anti-HBc was higher in the B-NHL group (16.2 ％ vs 11.5 ％,x2 =4.542,P =0.033).Significantly higher rate of positive anti-HBc and negative anti-HBs was observed in the B-NHL group (37.0 ％ vs 24.5 ％,Wald =17.708,P ＜ 0.001),whereas the same group showed a lower rate of negative anti-HBs compared with the control group (20.8 ％ vs 27.8 ％, Wald =5.646, P =0.017).Conclusion This finding of a positive association between HBV infection and B-NHL suggests that HBV may play an etiologic role in the induction of B-NHL.