HBsAg对乙型肝炎病毒感染患者病情进展及癌变的研究  

Study on the effect of HBsAg on progression of HBV infection and arcinogenesis

作　　者：李延玲[1] 张怀宏[1] 

机构地区：[1]南阳市中心医院感染肝病科,河南南阳473000

出　　处：《中华医院感染学杂志》2014年第19期4717-4719,共3页Chinese Journal of Nosocomiology

基　　金：河南省自然科学基金资助项目(0511043700)

摘　　要：目的探讨HBsAg对乙型肝炎病毒(HBV)感染相关性肝病患者病情进展的作用以及对癌变过程的影响,为临床提供科学依据。方法选择2009年12月-2013年8月390例行肝穿刺或手术切除的HBV感染肝病患者为研究对象,采用免疫组织化学的方法检测194例HBV慢性感染者、102例肝硬化(LC)和94例肝细胞癌(HCC)患者肝组织中HBsAg与Fas和其配体(FasL)的表达,并分析HBsAg与Fas、FasL表达的相关性。结果HBV的慢性感染者、LC和HCC患者肝组织中的HBsAg的表达阳性率分别为72.2%、60.2%和64.9%,FasL表达阳性率分别为39.2%、49.0%和58.5%,3组的阳性率和表达强度比较,差异无统计学意义;肝细胞中Fas表达阳性率分别为31.5%、17.4%和3.2%,肝内淋巴细胞中FasL表达阳性率分别为70.1%、57.1%和88.3%,其组间比较,差异无统计学意义,而其表达强度比较,差异有统计学意义(P<0.01),尤其是HCC患者的表达强度要显著的高于HBV慢性感染者,差异有统计学意义(P<0.01);HBsAg与Fas和FaSL表达强度存在相关性。结论 HBsAg对HBV感染相关性患者的各期均起了重要的作用,在早期主要通过增加肝细胞Fas表达从而诱导肝细胞凋亡的发生,使肝脏的炎症坏死加重,而在后期则主要增加肝细胞FasL表达以产生免疫逃避,这在肝细胞的癌变中起重要的作用。OBJECTIVE To explore the effect of HBsAg on progression of HBV infection related liver diseases and arcinogenesis,and provide a scientific basis for clinical treatment.METHODS Totally 390 patients with HBV infection related liver diseases undergoing liver puncture or excision in our hospital from Dec.2009 to Aug.2013 joined this research.The immunohistochemistry method was used to test the HBsAg and Fas expression in 194 patients with chronic HBV infection,and 102 patients with liver cirrhosis（LC）and 94 patients with hepatocellular carcinoma（HCC）.And the correlation between the expression of HBsAg and Fas,FasL were analyzed.RESULTS The positive expression rate of HBsAg in liver tissues of chronic HBV infected patients,LC and HCC were respectively 72.2%,60.2%and 64.9%,and the positive expression rate of FasL was 39.2%,49.0%and58.5%,there was no significant difference in positive rate and the intensity of expression among the three groups.The positive rate of Fas expression in liver cells in three groups was 31.5%,17.4%and 3.2%,and the positive rate of FasL in intrahepatic lymphocytes in three groups was 70.1%,57.1% and 88.3%,with no significant differences among the groups,but the differences in the expression intensity were significant（P〈0.01）.Particularly,the expression intensity in HCC patients was significantly higher than patients with chronic HBV infection（P〈0.01）.There were strong correlation between HBsAg and the expression of Fas and FaSL.CONCLUSION In the early stage of chronic HBV infection,HBsAg may induce apoptosis of liver cells by increasing the expression of hepatic Fas cells.And in the later stage,it may produce immune evasion by increasing expression of hepatic FasL cells,which plays an important role in the carcinogenesis of liver cells.

关 键 词：HBSAG 乙型肝炎病毒 免疫组织化学 细胞凋亡 

分 类 号：R512.62[医药卫生—内科学]