肝细胞肝癌与乙、丙及庚型肝炎病毒感染相关的组织学证据

HISTOLOGICAL EVIDENCE ON TRE RELATION OF HEPATOCELLULAR CARCINOMA TO HEPATITIS B,C AND G VIRUS INFECTION

目的探讨肝细胞肝癌（HCC）与乙、丙及庚型肝炎病毒（HBV，HCV，HGV）感染的相关性。方法采用免疫组化方法检测HCC患者癌及癌旁肝组织中HBV，HCV及HGV表达状况。结果65例HCC患者中，共计52例（80．0％）检出以上三种肝炎病毒抗原，其中乙型肝炎表面抗原（HBsAg），HCVNSS和HGVNSS抗原阳性者分别为47（72．3％），30（46．2％）和10（15．4％）例。52例病毒标志阳性者中，HBV，HCV和HGV三重感染者5例，HBV／HCV，HBV／HGV或HCV／HGV二重感染者各25例，单纯HBV和HCV阳性者各18例和4例，无单纯HGV阳性者。各病毒主要在癌旁组织中表达，但HBV和HCV在癌组织中也较活跃。此外，间或可在肿瘤与正常组织移行处检出HBV或HCV表达，但未见HGV抗原阳性。混合感染、单独感染及病毒标志阴性的HCC比较，肿瘤分化程度无明显区别。结论我国HCC患者肝炎病毒混合感染普遍存在；除HBV和HCV外，HGV感染也可能与肝癌发生有一定关系。

Purpose To evaluate the relationship of hepatocellular carcinoma (HCC) with hepatitis B,C,and G virus (HBV,HCV, HGV ) histologically. Methods Expres s ion of HBV, HCV and HGV in I ive r ti ss u e of 6 5 ca s e s with HCC wa s detec ted with immunohistochemical method. Results Totally 52 (80%) subjects had detected hepatitis B surface antigen (HBsAg),HCV HS5,or HGV NSS antigen in liver tissue of 65 HCC cases. The positive rates of the three antigens were 72. 3%, 46. 2%, and 15. 4%,respectively. Among the 52 cases with viral antigen positive, 5 were triple infection of HBV,HCV,and HGV, 25 were dual infection of HBV/HCV,HBV/HGV,or HCV/HGV, 18 were single HBV infection,and 4 single HCV infection. None of single HGV infection was found. All the three viral antigens were detected mainly in noncancerous tissue,but HBV as well as HCV also had a dynamic expression in cancerous cells. Furthermore,HBV and HCV antigen could occasionally be detected in the transition zone from normal to tumor tissue. The differentiation of tumor had no obviously difference among patients with different viral markers. Conclusion Both HBV and HCV infection,as well as mixed infection of several hepatitis virus were very common in Chinese patients with HCC.Besides HBV and HCV infection,HGV infection might also has some role in the oncogenesis of HCC.