慢性肝病颗粒酶-B及凋亡相关蛋白表达的研究  

Expression of granzyme-B and apoptosis protein in patients of chronic liver disease

作　　者：陈乃玲[1] 白玲[2] 邓涛[1] 张昶[2] 陈昊[2] 

机构地区：[1]北京军区总医院,北京100700 [2]连云港市第一人民医院,江苏连云港222002

出　　处：《军医进修学院学报》2004年第3期200-202,共3页Academic Journal of Pla Postgraduate Medical School

基　　金：国家自然科学基金资助项目 (3 9770 660 );北京军区重点课题资助项目 (95B0 0 8)

摘　　要：目的 :探讨主要起坏死作用的颗粒酶 B(GrB)与凋亡蛋白在慢性肝病肝细胞的表达及与乙型肝炎病毒抗原表达的关系。方法 :77例慢性肝病患者中 ,慢性肝炎 (CH) 32例 ,肝炎后肝硬化 (LC) 14例 ,原发性肝癌 (HCC)31例 ,采用原位杂交法检测TNF α、TNFR ,用免疫组化SP法检测GrB、Fas、FasL、Bax、Bcl 2、Bcl XL、Bcl 2α及HBsAg、HBcAg在其肝组织中的表达。结果 :GrB在三种慢性肝病肝细胞中表达未见显著性差异 ;促凋亡蛋白Fas、Fasl表达在LC组高于HCC组 (P <0 .0 5、0 .0 1) ,抑凋亡蛋白Bcl 2在LC及HCC组表达明显高于CH组 (P <0 .0 0 1、0 .0 1) ;HBcAg表达在HCC组较LC组显著增多 ,前者 6 1.2 9% ( 19/ 31)、后者 2 8.5 7% ( 4 / 14 ) ,P <0 .0 5。CH组GrB随着表达程度的增强 :( + ) 8例、( ) 3例、( ) 5例炎症组织学活动指数 (HAI)均值逐渐升高 :为 4 .88、5 .34、8.4 0。结论 :促坏死的GrB对慢性肝炎肝脏炎症活动有较明显相关关系。抑凋亡蛋白Bcl 2在肝硬化及肝癌表达较明显 ,在慢性肝病时坏死。Objective:Despite the presumed fundamental difference between apoptosis and necrosis the recent study supports the view that in case of ischemia /reperfusion the apoptosis may divert to necrosis(necrapoptosis).It is to analyse the expression of granzyme –B(GrB)、pro-apoptotic and anti-apoptotic protien and viral hepatitis B antigen (HBV antigen) in the hepatocytes of the chronic liver disease patients.Methods:the GrB、.apoptosis protein and HBV antigen in the liver tissue was studied by immunohistochemistry and in situ hybridization.Seventy seven cases of liver diseases,among them 32 cases of chronic hepatitis (CH),14 cases of liver cirrhosis(LC) and 31 cases of hepatocellular carcinoma(HCC).were studied. Results:There were no significant difference in the expression level of GrB among the three groups. The expression levels of pro-apoptosis protein Fas、FasL in the LC group were significantly higher than that in HCC group ( P <0.05、0.01). The expression levels of anti-apoptotic protein Bcl-2 in the LC and HCC groups were significantly higher than in CH group ( P <0.001、0.01). The expression levels of HBcAg in the HCC group is 61.29%(19/31),significantly higher than that of LC group 28.5%(4/14), P <0.05. Conclusion:The expression of necrosis factor GrB were correlated with the activity of the inflammation of the liver (HAI).The expression of anti-apoptotic protein Bcl-2 were higher in liver cirrhosis and HCC than in hepatitis. The relation between the expression of HBV antigon and expression of GrB and apoptosis protein needs further study.

关 键 词：慢性肝病 颗粒酶-B 凋亡相关蛋白 原发性肝癌 乙型肝炎 检测 

分 类 号：R512.6[医药卫生—内科学]