摘要目的:探讨可溶性sPD-1循环水平和PD-1基因多态性与HBV感染以及HBV感染相关性肝癌的关联。方法:采用病例对照研究方法，选择2018—2021年山西医科大学第一医院感染病科在院237例慢性HBV感染病例和138例HBV感染相关性肝癌病例作为病例组，随机选取该医院体检中心250例常规体检者为健康对照组。采用ELISA试剂盒测定血浆sPD-1水平，采用聚合酶链式反应-限制性片段长度多态性（PCR-RFLP）技术进行基因分型。分别以sPD-1水平和PD-1基因多态性为自变量，分别以HBV感染以及HBV感染相关性肝癌为因变量，调整年龄、性别、饮酒、吸烟、ALT和AST水平后，采用logistic回归模型分析sPD-1水平和PD-1基因多态性与HBV感染以及HBV感染相关肝癌的关联。结果:237例慢性HBV感染、138例HBV感染相关性肝癌病例组和250例对照组研究对象的年龄分别为（49.1±10.8）、（51.9±12.7）和（50.7±11.9）岁。多因素logistic回归模型分析结果显示，随着sPD-1水平每升高1 pg/ml，HBV感染和HBV感染相关肝癌的发生风险 OR（95% CI）值分别为1.92（1.68~2.19）、2.02（1.69~2.40）；对于rs2227981，与CC基因型相比，TT基因型感染HBV、罹患HBV感染相关肝癌的风险较低， OR（95% CI）值分别为0.45（0.22~0.91）、0.35（0.14~0.91）；对于rs2227982，与CC基因型相比，CT、TT基因型感染HBV［ OR（95% CI）值分别为0.72（0.53~0.97）、0.57（0.35~0.93）］和罹患HBV感染相关肝癌风险均较低［ OR（95% CI）值分别为0.64（0.45~0.92）、0.52（0.29~0.93）］。 结论:血浆sPD-1水平、PD-1基因多态性与HBV感染以及HBV感染相关性肝癌均有关联。

abstractsObjective:To investigate the association of circulating sPD-1 level and PD-1 gene polymorphisms with HBV infection and HBV infection-associated hepatocellular carcinoma.Methods:A case-control study was conducted. A total of 237 chronic HBV infection cases and 138 HBV infection-associated hepatocellular carcinoma in the Department of Infectious Diseases of the First Hospital of Shanxi Medical University from 2018 to 2021 were selected as the case group. About 250 individuals who visited a hospital physical examination center for routine physical examination during the same period were selected as the control group. Plasma sPD-1 levels were measured by using an ELISA kit and genotyping was performed by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The association of sPD-1 levels and PD-1 polymorphisms with HBV infection as well as HBV infection-associated hepatocellular carcinoma was analyzed by using logistic regression models after adjusting for age, sex, alcohol consumption, smoking, ALT and AST levels. The sPD-1 level and PD-1 polymorphisms were independent variables, and HBV infection was the dependent variable.Results:The age of 237 chronic HBV infections, 138 HBV infection-related liver cancer case subjects and 250 control subjects in the study was (49.1±10.8), (51.9±12.7) and (50.7±11.9) years, respectively. Multivariate logistic regression model analysis showed that with a 1 pg/ml increase in sPD-1 level, the OR (95% CI) values for the risk of incident HBV infection cases and HBV hepatocellular carcinoma cases were 1.92 (1.68-2.19) and 2.02 (1.69-2.40). For rs2227981, compared with the CC genotype, the TT genotype had a lower risk of HBV infection and liver cancer associated with HBV infection, with OR (95% CI) values of 0.45 (0.22-0.91) and 0.35 (0.14-0.91). For rs2227982, compared with the CC genotype, the CT and TT genotypes also had a lower risk of HBV infection [ OR (95% CI) values of 0.72 (0.53-0.97) and 0.57 (0.35-0.93)] and HBV infection-related liver cancer [ OR (95% CI) values of 0.64 (0.45-0.92) and 0.52 (0.29-0.93)]. Conclusions:Plasma sPD-1 levels and PD-1 gene polymorphisms are associated with HBV infection and HBV infection-associated hepatocellular carcinoma.