HBsAg、HBcAg在慢性乙型肝炎肝细胞内的表达及临床意义  

Expression and clinical significance of HBsAg and HBcAg in hepatocytes in chronic hepatitis B

作　　者：王功遂[1] 王曼曼[2] 谢秋里[1] 明朗[1] 姜湘宁[1] 陈乐无[1] 刘梅华[1] 

机构地区：[1]广东省顺德第一人民医院,顺德528300 [2]广州中山大学第三附属医院

出　　处：《中华肝脏病杂志》2004年第5期287-289,共3页Chinese Journal of Hepatology

摘　　要：目的 探讨HBsAg、HBcAg在慢性乙型肝炎(CHB)患者肝细胞内的表达,及其与血浆HBVDNA定量、肝组织病理和临床间的关系。 方法 采用PCR检测351例CHB患者血浆HBV DNA定量,肝穿刺活检,采用免疫组织化学技术观察肝细胞内HBsAg、HBcAg的表达。 结果 在CHB患者肝细胞内HBsAg和HBcAg阳性表达率分别为92.3％和76.9％。HBcAg浆膜型(75.6％)和胞核型(24.4％)分别见于肝组织炎症较活跃和较静止期CHB。HBsAg表达强度与血浆HBV DNA定量呈较低正向关联(rp=0.24,P=0.0129)、与肝组织炎症和纤维化呈较低负向关联(rp=-0.22,P=0.0279和rp=-0.23,P=0.0186)。HBcAg的表达强度随着血浆HBV DNA定量的增加而增加,呈较强正向关联(rp=0.52,P<0.0001),随着肝组织炎症和纤维化程度的加重而减弱,呈较强的负向关联(rp=-0.33,P<0.0001和rp=-0.34,P<0.0001)。 结论 在CHB肝组织免疫损伤的免疫应答中,HBcAg是靶抗原,HBsAg不一定是靶抗原。HBsAg是筛查HBV感染的较敏感指标,HBcAg是评价HBV复制程度的较可靠指标。Objective To study the expression of HBsAg and HBcAg in hepatocytes in CHB patients, and analyze the correlation among the expression of HBsAg and HBcAg, the quantity of HBV DNA in serum, the pathology of liver tissue and the clinical manifestation. Methods Quantitative polymerase chain reaction was used to assay the quantity of HBV DNA in serum in 351 CHB patients. Furthermore pathological diagnosis was performed using liver biopsy to assay the expression of HBsAg and HBcAg in hepatocytes by an immunohistochemical staining technique. Results The positive expression rate of HBsAg and HBcAg in hepatocytes was 92.3% and 76.9% respectively. Cytoplasmmembrane HBcAg expression type(75.6%) was observed in the CHB with more active inflammation, while Nucleus HBcAg expression type(24.4%) was observed in the CHB with more sedative one(P<0.0001). The expression of HBsAg was correlated with the quantity of HBV DNA in serum (rp=0.24, P=0.0129,), while inversely correlated with the inflammation and the fibrillation of liver tissue(rp=-0.22, P=0.0279; rp=-0.23, P=0.0186). The expression of HBcAg was correlated with the quantity of HBV DNA in serum(rp=0.52, P<0.0001), while was inversely correlated with the inflammation and the fibrosis of liver(rp=-0.33, P<0.0001; rp=-0.34, P<0.0001). Conclusion Cytoplasmmembrane HBcAg expression type was observed in the CHB with more active inflammation, while Nucleus HBcAg expression type was observed in the CHB with mild change. In the immunopathogenesis of the liver damage in CHB, HBcAg might be a main target antigen. HBsAg might be a sensitive index to screen HBV infection; HBcAg might probably be a reliable index to evaluate the replication of HBV.

关 键 词：HBSAG HBCAG 慢性乙型肝炎 CHB 免疫应答 靶抗原 肝纤维化 免疫组织化学 核心抗原 表面抗原 

分 类 号：R512.62[医药卫生—内科学] R392.11[医药卫生—临床医学]