肝病患者中丙型肝炎病毒感染的免疫组化检测

IMMUNOHISTOCHEMICAL DETECTION OF HCV INFECTION IN PATIENTS WITH HEPATOCELLULAR CARCINOMA AND OTHER LIVER DISEASES

以ＨＣＶＮＳ３区单克隆抗体、ＬＳＡＢ法检测了１１６例各类肝病肝组织（其中肝细胞癌５２例，肝炎后肝硬化１６例，慢性肝炎４０例，体质性黄疸８例）及６份正常肝组织（作为对照）中ＨＣＶ抗原的表达状况，结果表明，ＨＣＶ抗原在肝细胞癌、肝炎后肝硬化及慢性肝炎中检出率分别为１３．５％（７／５２）、１２．５％（２／１６）、１０％（４／４０），而在体质性黄疸及正常肝组织中未检出ＨＣＶ抗原。ＨＣＶ抗原可见于癌细胞或癌周肝细胞的胞浆或胞核中，实验结果支持ＨＣＶ与肝细胞癌的关联，ＨＣＶ感染对促使肝病的加重也具有一定影响。肝细胞癌中，胞核型ＨＣＶ抗原表达较多见。癌周组织中ＨＣＶ抗原检出率高于癌组织，提示ＨＣＶ可能主要作用于癌前病变，在肝细胞癌发生的初始阶段起作用，促使正常细胞恶性化。

Using labelled streptoavidin biotin (LSAB) method with monoclonal antibody to NS3 region of HCV genome, we detected the expression of HCV antigen in the liver tissues of different liver deseases (HCC, 52 cases; cirrhosis, 16 cases; chronic hepatitis, 40 cases; constitutional jaundice, 8 cases) and 6 normal liver samples as negative control. The results showed that in the three groups of HCC, cirrhosis and chronic hepatitis, the positive rates of HCV antigen were respectively 13.5%(7/52), 12.5%(2/16), and 10%(4/40), while in the samples from patients with constitutional jaundice and normal liver samples, no HCV antigen was found. HCV antigen could be seen in the nuclei or/and cytoplasms of carcinoma cells and/or pericancerous hepatocytes. The results supported the view that HCV is associated with HCC and HCV infection enhances the development of liver diseases. In HCC, HCV antigen was more often seen in nuclei than in cytoplasms. The positive rate of HCV antigen in pericancerous tissues was higher than in cancerous tissues, and this result indicated that HCV affects the initiative period of HCC and induces the malignant phenotypic alteration of hepatocytes.