Clinical Analysis Of HBV Infection In 139 Cases With Lymphoma

Objective:To analysis the prevalence of hepatitis B virus(HBV) and the relationship between HBV infection and sex, age, lactate dehydrogenase(LDH), pathological types, stages, IPI score in 139 cases with lymphoma, as well as the influence of chemotherapy on HBV reactivation and liver dysfunction in patients with lymphoma.Methods:A retrospective study was done about the clinical, laboratory and follow-up data among the patients who were diagnosised with malignant lymphoma by pathological examination. We finally selected 139 patients who were treated in the First Hospital of Lanzhou University from January 2010 to October 2015.Results:1. The positive rate of HBs Ag Sex: 11.96% in male patients and 12.77% in female patients. There was no statistical difference.(P=0.890). Age: 10.45% in patients with age <50 and 13.89% in patients with age ≥50. There was no statistical difference.(P=0.536). LDH: 16.67% in patients with high level, 10.42% in patients with normal level and 14.29% in patients with low level. There was no statistical difference among each group(P= 0.436). Pathological types: 9.52% in patients with Hodgkin lymphoma and 12.71% in patients with non-Hodgkin lymphoma. 21.57% in patients with diffuse large B cell lymphoma, which was much higher than that in patients with other pathological subtypes of NHL. There was no statistical difference among each pathological subtype of patients with lymphoma(P>0.05). Stages: 40% in stage III~IV patients with HL and 0% in stage I~II patients with HL. There was significantly statistical difference between the two groups(P=0.048). 18.18% in stage III~IV patients with NHL and 2.44% in stage I~II patients with NHL(2.44%). There was significantly statistical difference between the two groups(P=0.015). IPI score: 20.75% in patients with IPI score ≥3 and 6.15% in patients with IPI score <3. There was significantly statistical difference between the two groups(P=0.018).2. The incidence of liver dysfunction: I degree was 4.44%, II degree was 3.70%, III degree was 0.74% and IV degree was 0% before chemotherapy, which was much lower than that during the course of chemotherapy(18.52%, 7.41%, 2.96% and 0.74% respectively) among the 135 patients with lymphoma who received chemotherapy. There was significantly statistical difference about the incidence of I degree liver dysfunction before chemotherapy and during the course of chemotherapy(P=0.000). There was no statistical difference about the incidence of II, III, IV degree liver damage before chemotherapy and during the course of chemotherapy(P=0.184, 0.367 and 1.000 respectively).3. The incidence of liver dysfunction was 4.67% in patients with HL, 15.79% in patients with T cell type NHL and 8.42% in patients with B cell type NHL before chemotherapy. There was no statistical difference among the three groups(P=0.478). The incidence of de novo or aggravated original liver dysfunction was 23.81%, 31.58% and 26.32% respectively among the three groups undergoing chemotherapy. There was no statistical difference among them(P=0.849). There was no statistical difference about the incidence of liver dysfunction before chemotherapy and during the course of chemotherapy in patients with HL and T cell type NHL(P=0.186 and 0.447 respectively). There was significantly statistical difference about the incidence of liver damage before chemotherapy and during the course of chemotherapy in patients with B cell type NHL(P=0.001).4. The incidence of liver dysfunction was 6.52% in HBs Ag carriers, 0% in HBs Ag negative and HBc Ab positive patients, 10.78% in patients without HBV infection before chemotherapy. There was no statistical difference among them(P=0.154). The incidence of de novo or aggravated original liver dysfunction was 43.75%, 29.41% and 23.53% respectively among the three groups undergoing chemotherapy. There was no statistical difference among them(P=0.253). There was significantly statistical difference about the incidence of liver dysfunction before chemotherapy and during the course of chemotherapy in each groups(P=0.041, 0.044 and 0.016 respectively).5. The incidence of liver dysfunction was 60% in patients with HBV reactivation and 32.14% in patients without HBV reactivation. There was no statistical difference between them(P=0.328).6. The incidence of chemotherapy delay was 60% in patients with HBV reactivation and 18.52% in patients without HBV reactivation. There was no statistical difference between them(P=0.085). Conclusion:1. The positive rate of HBs Ag in patients with lymphoma was much higher than that in the general population and it might have no correlation with sex, age, LDH level and pathological types in patients with lymphoma.2. The relationship between HBV infection and highly malignant lymphoma was much closer than that with low degree malignant lymphoma which could speculate that HBV infection might promote the development of lymphoma.3. Chemotherapy could increase the risk of liver dysfunction in patients with lymphoma, especially with B cell type NHL. It’s necessary to strengthen the liver protection in the process of chemotherapy especially with B cell type NHL.