基于HBeAg与HBsAg定量的HBV相关肝癌风险精准分层

摘要/Abstract

摘要： 在乙型肝炎病毒(HBV)相关肝细胞癌(HCC)的风险预测体系中,乙型肝炎e抗原(HBeAg)状态与乙型肝炎表面抗原(HBsAg)定量检测各自都有不容忽视的临床价值。过去学界普遍认为,在免疫耐受期,由于肝脏炎症反应轻微,肝癌的发生风险较低,但近年来,几项长期随访队列的结果表明这一传统认识面临挑战。研究证实,HBeAg阳性和阴性的感染者,其肝癌的发生风险特征存在明显不同,对于HBeAg阳性人群而言,高水平的HBsAg与HCC风险呈现反向关联,这恰恰给临床上区分“真性免疫耐受”的患者和看似耐受实则高危的“伪免疫耐受”患者提供了关键依据。综上所述,在考虑代谢相关危险因素及疾病自然史演变过程中,将HBsAg定量参数引入目前的HCC风险分层模型中,可以更好地指导抗病毒治疗的最佳时机,从而为进一步制定个体化随访干预方案提供更多科学依据。

关键词: 慢性乙型肝炎, 肝细胞癌, 乙型肝炎表面抗原, 乙型肝炎e抗原, 免疫耐受

王建鲁, 孙剑, 申笙. 基于HBeAg与HBsAg定量的HBV相关肝癌风险精准分层[J]. 肝脏, 2026, 31(5): 599-602.

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