83例原发性肝癌患者自身抗体检测结果分析

Analysis of autoantibodies in 83 patients with primary hepatic carcinnoma

目的:探讨原发性肝癌患者自身抗体产生的规律及临床意义。方法:以临床诊断为原发性肝癌患者83例作为研究对象,采用间接免疫荧光法及免疫印迹法检测患者血清中自身抗体。结果:83例肝癌患者自身抗体检出率为37.3%(31/83),其中HBV感染患者检出率35.9%(23/64),HCV感染者检出率50.0%(8/16),二者差异无统计学意义(P>0.05)。能检测到一种、两种及三种自身抗体的患者分别为24.1%、12.1%和1.2%。抗核抗体(ANA)、抗细胞骨架抗体(CS)、抗平滑肌抗体(SMA)和抗线粒体抗体(AMA)的检出率分别为24.1%、13.3%、9.6%和4.8%。抗核抗体谱分析有Ro-52、CENP-B(着丝点B抗原)等自身抗体阳性。AFP(甲胎蛋白)异常及AFP正常的患者自身抗体检出率分别为36.8%和22.2%,差异无统计学意义(P>0.05)。HBV-DNA阳性与HBV-DNA阴性患者自身抗体检出率分别为40.5%和27.3%,差异无统计学意义。女性患者自身抗体检出率明显高于男性,差异有统计学意义。结论:37.3%的原发性肝癌患者能检测到非器官特异性的自身抗体:ANA、CS、SMA和AMA,大多患者以检出其中一种抗体为主,部分患者能检出二至三种自身抗体。ANA、CS、SMA和AMA四种自身抗体中检出率最高的是ANA,其次是CS和SMA,检出率最低的是AMA。各抗体均以低滴度为主。ANA荧光模型以颗粒型为主。血清AFP含量的高低与自身抗体检出率之间未见明显相关性。HBV-DNA阳性患者与HBV-DNA阴性患者自身抗体检出率差异无统计学意义。女性患者自身抗体检出率明显高于男性。

Objective：To study the characteristics of autoantibodies in patients with primary hepatocellular carcinoma（HCC）.Methods：83 patients with primary hepatocellular carcinoma（HCC）were studied.Different autoantibodies were detected by indirect immunofluorescent assay（IIF,Euroimmuno,Germany）.Results：31 of 83 cases were found autoantibodies（37.3%）,in whom 64 patients were in HBV infection,with 23 autoantibodies positive（35.9%）.8 were autoantibody-positive in 16 patients with HCV infection（50.0%）.There was no significant differences between the two groups（P0.05）.24.1%（20/83）or 12.1%（10/83）or 1.2%（1/83）patients were positive for one,two or three kinds of autoantibodies respectively.Anti-nuclear antibody（ANA）was the most popular（24.1%）than others.Anti-cytoskeleton（CS）was 13.3%,whereas anti-smooth muscle antibody（SMA）was 9.6% and anti-mitochondria antibody（AMA）4.8% respectively.It was shown that anti-Ro-52 or anti-CENP-B was positive by ANA analysis.Comparing AFP normal with abnormal patients,antoantibody rate（22.2% vs 36.8%）had no significant difference.There were no remarkable difference between autoantibodies positive group and autoantibodies negative group for HBV-DNA.Conclusion：Non-organ-specific autoantibodies—ANA,CS,SMA and AMA can be detected in 37.3% patients with HCC.The highest detection rate is ANA,the next is CS and SMA,and the lowest is AMA.All of detected autoantibodies are shown with low titer（1∶100）.Concentration of AFP and autoantibodies is not shown significant correlation.There is no remarkable difference in autoantibodies between HBV-DNA positive group and negative group.