乙型肝炎病毒感染与肝细胞癌发生的关系  

Expression of Alpha Fetoprotein and Its Relationship with HBV Infection in Hepatocellular Carcinomas

作　　者：申丽娟[1] 章宗籍[1] 张华献[1] 杨微波[2] 黄润[1] 

机构地区：[1]昆明医学院病理学教研室,650031 [2]昆明医学院第一附属医院传染科,650032

出　　处：《实用癌症杂志》2002年第2期162-163,共2页The Practical Journal of Cancer

基　　金：云南省自然科学基金(2000C0058M);云南省教委科学研究基金(0011010)资助

摘　　要：目的　探讨乙型肝炎病毒 (HBV )的可能致癌机理。方法　采用免疫组化和原位分子杂交方法 ,对慢性乙型肝炎、肝硬化、癌旁肝硬化、肝细胞癌和正常肝组织中的乙型肝炎表面抗原 (HBsAg)、核心抗原 (HBcAg)、HBVDNA和甲胎蛋白 (AFP)水平进行检测。结果　HBsAg、HBcAg和HBVDNA的阳性率在慢性乙型肝炎组中分别为 61.9% ( 13/2 1)、42 .9% ( 9/2 1)、75 .0 %( 12 /16) ;在肝硬化组中分别为 64 .0 % ( 16/2 5 )、36.0 % ( 9/2 5 )、83.3% ( 15 /18) ;在癌旁肝硬化组中分别为 72 .7% ( 16/2 2 )、61.1%( 11/18)、85 .7% ( 12 /14 ) ;在肝细胞癌组中分别为 45 .2 % ( 14 /31)、5 0 .0 % ( 14 /2 8)、64 .3% ( 9/14 )。慢性乙型肝炎、肝硬化和癌旁肝硬化组中HBVDNA阳性信号较肝细胞癌多而强。AFP仅在癌旁肝硬化 ( 33.3% ,9/2 7)和肝细胞癌 ( 43.6% ,17/39)组中表达 ,而在慢性肝炎和肝硬化组中不表达 ,癌旁肝硬化与不伴肝癌的肝硬化有非常显著性差异 (P <0 .0 1)。结论　大多数肝细胞癌的发生与HBV感染所致的慢性乙型肝炎和肝硬化密切相关 ,癌旁肝硬化可能是癌前肝硬化在癌周的残留。Objective To study the possible carcinogenesis of hepatitis B virus(HBV).Methods HBsAg,HBcAg,HBV DNA and AFP were detected by immunohistochemical staining and in situ hybridization in total 94 cases of liver tissue including chronic hepatitis B,liver cirrhosis,paratumor cirrhosis,hepatocellular carcinoma (HCC) and normal control.Results The positive rates of HBsAg,HBcAg and HBV DNA were 61.9%(13/21),42.9%(9/21) and 75.0%(12/16) in chronic hepatitis B ;64.0%(16/25),36.0%(9/25) and 83.3%(15/18) in liver cirrhosis;72.7%(16/22),61.1%(11/18) and 85.7%(12/14) in the paratumor cirrhosis,as well as 45.0%(14/31),50.0%(14/28) and 64.3%(9/14) in HCC.HBV DNA granules signal in chronic hepatitis B,liver cirrhosis and the paratumor cirrhosis was more and stronger than that in HCC.The positive rates of AFP were 33.3%(9/27) in the paratumor cirrhosis and 43.6%(17/39) in HCC.AFP were negative in chronic hepatitis B and liver cirrhosis.Conclusion Most of the HCC cases are closely associated with chronic hepatitis B and liver cirrhosis with HBV infection.The paratumor cirrhosis may be a sequential lesion of precancerous cirrhosis around HCC.

关 键 词：肝肿瘤 乙型肝炎病毒 甲胎蛋白 免疫组织化学 原位杂交 肝细胞癌 

分 类 号：R735.7[医药卫生—肿瘤] R512.62[医药卫生—临床医学]