原发性肝癌丙肝病毒基因及其抗体的检测

Detection of hepatitis C virus genome and antibodies in hepatocellular carcinoma

本文报道运用巢式PCR,ELISA等方法检测我国原发性肝癌,癌旁组织和外周血中HCV-RNA抗-HCV,同时监测了HBsAg。所用引物位于HCV基因5’-端非编码区域。结果76例肝癌病人血清中抗-HCV阳性9.2％(7/76),HCV-RNA阳性13.2％(10/76);34例肝癌组织中HCV-RNA阳性11.8％(4/34),1例抗HCV阴性的病人在癌及癌旁组织中检测到ECV-RNA,提示我国HCC的发生与HCV感染有一定关系。本组检测10例HCV-RNA阳性,其中4例(40％)系第二步扩增后检出,说明巢式PCR确可显著提高HCV-RNA检出率,单纯用C100-3抗体检测有可能低估HCC中HCV的感染率。本研究还发现HCV-RNA阳性的HCC中HBsAg检出率高于HCV-RNA阴性HCC者,(P<0.05),说明在我国HCC的发生中,HCV可单独存在,但更常与HBV共同作用。

Sere and tissue obtained form patients with hepatocellular carcinoma were examined for the presence of hepatitis C Virus (HCV)genome by the 'nested' (two-stage) polymerasechain reaction (PCR) assay, for antibody to HCV (ANTI-HCV) by using an enzymelinked immuno- sorbent assay (ELISA), as well as for the presence of serum hepatitis B surface antigen (HBsAG). Two parts of primers were deduced from the highly conserved 5＇-noncoding region of HCV genome. Among 76 pstients, HCV-RNA was detected in 10(13.2%), and the antibody was also found to be positive in 7(9.2%) of them. HCV-RNA was detected in 4 out of 34(11.8%) tumor tissue specimens. A test result in a patient who was negative for anti-HCV, was positive for HCV-RNA in tumor and pericancerous nontumor liver tissue indicates that, a relatively greater possible role of HCV infection in the etiology of HCC in our country 10 patients who were positive for HCV-RNA, 6(60%) and showed positive results at the firststage of PCR, 4(40%) were positive at the secondstage as well. These findings suggest that the prevalence of HCV infection may be underestimated by mere detection of antibody to HCV. In 4 cases with HCV-RNA, 3 were positive for HBsAG (75%). HBV appears to be the more important etiologic agent. HCV can act alone, but frequently in conjunction with HBV in the pathoge- nesis of HCC.