The Effect Of Different Nucleoside Analogs Therapy On Chronic Severe Hepatitis B & Expression And Significance Of YKL-40 Protein In Hepatocellular Carcinoma

PartⅠThe effect of different nucleoside analogs therapy on chronic severe hepatitis BBackground and Aims:Chronic severe hepatitis B often results in limited survival. This investigation aimed to evaluate the long-term effects of nucleoside analogs therapy in chronic severe hepatitis B.Methods:We retrospectively randomly collected the data of 301 chronic severe hepatitis B patients.41 were treated with entecavir,41 were treated with lamivudine,and the remaining 219 were not treated with any antiviral drug.Results:1) One-year treatment of nucleoside-naive patients with entecavir 0.5 mg and with lamivudine 100 mg were well tolerated,and compared to none-nucleoside analogues treated patients,had no significantly difference in survival rate(P＞0.05).2) Although antiviral groups reduced HBV replication rapidly during the same therapy time,the model for end-stage liver disease(MELD) score had no significant changes(P＞0.05).3) Furthermore,we analyzed the MELD score and 1-year survival rate in patients with different levels of HBV-DNA(HBV-DNA level≤10~4 copies/ml,＞10~4 to＜10~6 copies/ml,≥10~6 copies/ml),no significantly difference was observed(P＞0.05).4) There was no significant correlation between HBV-DNA level and MELD score in different therapy time(P＞0.05).5) However,some parameters of liver function(international normalized ratio,total bilirubin,MELD score) showed significant difference(P＜0.05) between two prognosis patients(survived over 1 year,survived less than 1 year).Conclusions:These results suggested short-term suppression of HBV replication may not reduce the severity of liver failure and surviral in chronic severe hepatitis B patients.Further study is needed on chronic severe hepatitis issues like assessing long-term curative effect,the partial virological response to nucleoside analogs,drug resistance,and more improved antiviral strategy. PartⅡExpression and significance of YKL-40 protein in hepatocellular carcinomaBackground and Objective:Overexpression of YKL-40 has been detected in the serum of patients with various kinds of malignant tumors,including hepatocellular carcinomar.Moreover,YKL-40 expression is closely related to clinical phenotypes of some malignant tumors.This study was to investigate the expression and clinical significance of YKL-40 protein in hepatocellular carcinoma.Methods:We dealed with tissues of 12 hepatocellular carcinoma specimens and the controlled specimens adjacent to those using immunohistochemistry.Compared to two sorts of specimens,YKL-40 protein expression was detected and analysed.Results:The expression of YKL-40 in all liver tissues next to hepatocellular carcinoma was negative or low.In 12 evaluable specimens of hepatocellular carcinoma,overexpression of YKL-40 was detected in all cases.The expression of YKL-40 protein is likely to correlate with that of clusterin protein in hepatocellular carcinoma.Conclusions:These results suggest YKL-40 may have the potential in monitoring hepatocellular arcinoma.YKL-40 may be used as a novel molecular marker which has the potential to contribute to early diagnosis and predict the prognosis of hepatocellular carcinoma.Functional roles of YKL-40 in liver might be taken into account when using YKL-40 as a non-invasive hepatocellular carcinoma marker. However,further studies are needed to verify this hypothesis.