To Explore The Correlation Of Circulating DNA And HBV-DNA Load With The PHC

Background:At present, the primary hepatic cancer(PHC) is one of the most common malignancies in the digestive system, and high mortality,90 percent of the primary hepatic cancer is hepatocellular carcinoma (HCC). There is a close relationship between the primary hepatic cancer and the viral hepatitis type B. Especially the liver fibrosis is the foundation of PHC after it turn to chronic hepatitis. As we know,the hepatitis B virus carriers more than 280 million all over the world, the numbers accounts for about half in China. At present our country has more than 30 million patients with viral hepatitis type B. Hepatitis B virus infection as the most common and main cause of the primary hepatic cancer has been assured by epidemiological studies. The surial of most patients with the primary hepatic cancer after diagnosis less than one year,the main reason is that many patients has attended into the later. At present, AFP is the most widely used tumor markers of PHC early diagnosis.However, AFP positive PHC patients accounted for about 65% of all PHC patients, there are still many patients lack of effective early diagnosis and prognosis index.The circulating DNA is a kind of extracellular DNA present in various body fluids,for example the blood, cerebrospinal fluid and synovial fluid. As early as 1947 Mandel and Metais have found circulating nucleic acid exists in body fluids. In 1977 Leon, et al. who first reported that the plasma DNA content of patients with tumor is higher than normal. After that, a lot of studies about all human tumour types, including liver cancer, lung cancer, breast cancer, gastrointestinal tumors, prostate cancer, ovarian cancer showed that the plasma DNA content of patients with tumor have different levels elevated. And the correlation studies of plasma DNA level and oncology clinic show that the plasma DNA level of high and low not only can signal the existence of the tumor, and the clinical stages, and whether there is a lymph node metastasis, tumor size and prognosis were related, but also can be used for good judgment index of cancer early diagnosis, prognosis and curative effect.In addition, circulating DNA detection have an advantage of price is lower, specimens for convenient, minimally invasive, it can be considered as a cancer screening index, but the specificity is poorer. At present, however, almost of the liver cancer markers is protein. The research of the tumor circulating DNA will be alternate a new way for tumor markers.The viral hepatitis type B is the most wide and serious harm infectious disease in our country. HBV-DNA load can reflect the appropriateness of the virus in the body, people often think that the virus copy related with the body's immune status,but often ignore the most fundamental question that the place of the virus copies constantly decline with the development of course after the liver fibrosis. With the development of the liver fibrosis, a small amount of virus copies can cause serious liver inflammatory lesions, continuous inflammatory stimulation can continually aggravating liver fibrosis, and the final induce PHC.Objective:From detect plasma DNA and HBV-DNA load in the viral hepatitis after liver cirrhosis in different periods,to explore the prevention, early diagnosis,illness turned over and prognosis value of united detect the plasma DNA and HBV-DNA load for PHC.Methods:Follow-up with QRT-PCR to test the hepatitis cirrhosis patients by Color B ultrasonic diagnosis who HBsAg is positive. To test the patients with plasma DNA and HBV-DNA load every three months, until diagnosis of PHC by the clinical symptoms, color B ultrasonic and CT.Results:Blood circulating DNA is 60.2±9.5ng/ml in PHC, health control group is 20.2±3.4ng/ml, two groups have significant difference (P<0.01), and HBV-DNA load is low level,78%≤105copies/ml, and have obvious difference with PHC who has not diagnosed (P<0.01).The blood circulating DNA of PHC who has not occurred lymph node metastasis is 51.2±7.9ng/ml, who has occurred lymph node metastasis is 73.9±10.7ng/ml, differences exist between them (P<0.05); But HBV-DNA load has not obvious difference whether lymph node metastasis.Conclusion:United detecting of the blood circulating DNA and HBV-DNA load for the forecasting and prognosis value of the PHC is obvious, and the method is simple, and easy to carry out.