慢性肝炎和肝癌病人血清中乙型肝炎病毒DNA的检测

Hepatitis B virus DNA detection by means of polymerase chain reaction in patients with chronic hepatitis and hepatocellular carcinoma

为了了解慢性肝炎和肝癌病人患者体内乙型肝炎病毒（ＨＢＶ）复制与ＨＢＶ血清标志之间的关系，用酶联免疫吸附实验（ＥＬＩＳＡ）、聚合酶链反应（ＰＣＲ）及斑点杂交方法对６１例慢性肝炎和４７例肝癌患者的ＨＢＶ表面抗原（ＨＢｓＡｇ）、相关ｅ抗原（ＨＢｅＡｇ）、表面抗体（抗－ＨＢｓ）、核心抗体（抗－ＨＢｃ）、相关ｅ抗体（抗－ＨＢｅ）进行了检测。结果表明：ＨＢＶＤＮＡ在ＨＢｓＡｇ、ＨＢｅＡｇ、／抗－ＨＢｃ阳性的慢性肝炎和肝癌患者血清中的检出率分别为９０．５０％和５０．００％；在ＨＢｓＡｇ／抗－ＨＢｅ、抗－ＨＢｃ阳性者的检出率分别为４５．４０％和７．１４％；在ＨＢｓＡｇ阳性、ＨＢｅＡｇ阴性／抗－ＨＢｅ阴性者中的检出率分别为６０．００％和４０．００％；ＨＢｓＡｇ阴性、／抗－ＨＢｃ阳性或／抗－ＨＢｅ阳性或／抗－ＨＢｓ阳性者中的检出率分别为２０．００％和２２．２２％；在血清学指标全阴性时，慢性肝炎和肝癌患者血清中ＨＢＶＤＮＡ的检出率均为０。实验提示：无论是肝炎或肝癌，在ＨＢｓＡｇ、ＨＢｅＡｇ同时阳性时，ＨＢＶ复制最为活跃；在单独ＨＢｓＡｇ阳性时，ＨＢＶ有一定程度的复制；ＨＢＶ复制在肝癌细胞中受到一定程度的抑制。

HBV immunological detection and HBV DNA detection by polymerase chain reaction (PCR) or molecular hybridization with 32 P labeled probe were done in 61 patients with chronic hepatitis (CH) and 47 patients with hepatocellular carcinoma (HCC) to investigate the relationship between HBV replication and serum markers. The HBV DNA was detected in 90.50% of CH patients and 50.00% of HCC patients with HBsAg, HBeAg and anti-HBc positive; in 45.40% of CH patients and 7.14% of HCC patients with HBsAg, anti-HBe and anti-HBc positive; in 60.00% of CH patients and 40.00% of HCC patients with HBsAg and negative HBeAg, anti-HBe positive; in 20.00% of CH patients and 22.22% of HCC patients with HBsAg negative and anti-HBc or anti-HBe or anti-HBs positive; in 0 of CH or HCC patients lack of HBV serum markers. Our data suggested that the most active HBV replication was correlated to the presence of both HBsAg and HBeAg, there were some extent of HBV replication in CH or HCC patients with positive HBsAg, the inhibition of HBV replication was related to anti-HBe, the less active HBV replication was seen in HCC patients when compared with CH patients.