乙型肝炎相关性肝细胞癌HBV复制及其癌组织中HBsAg/HBcAg表达的研究

HBV DNA Level and the expression of HBsAg/HBcAg in patients with HBV-related hepatocellular carcinoma

目的以慢性乙型肝炎(chronic hepatitisB,CHB)患者为对照,观察乙型肝炎相关性肝细胞癌(hepatocellular carcinoma,HCC)患者血清中HBVDNA水平的变化,以及HCC组织中HBsAg/HBcAg的表达情况,探讨HBV导致HCC的可能机制。方法 HCC组89例,CHB组120例。采用实时定量PCR法检测血清HBVDNA水平;分别留取肝脏穿刺组织标本(HCC组织均带有癌旁肝硬化组织),用免疫组化法检测组织中HBsAg/HBcAg的表达情况。结果 HCC组血清HBVDNA水平明显低于CHB组(P<0.05);在CHB组织、癌旁肝硬化组织和HCC组织中HBsAg表达阳性率分别为90%、51%和10%,HBcAg阳性率分别为78%、19%和3%,与CHB组织、癌旁肝硬化组织相比,HCC组织中2种抗原表达均明显较低(P均<0.05)。结论在HBV慢性感染不同疾病阶段,血清HBVDNA水平和HBsAg/HBcAg在肝组织内的表达具有显著差异;与CHB组相比,HCC组HBVDNA水平较低,HBsAg/HBcAg表达显著缺失,这可能与HCC患者HBVDNA复制水平降低有关,但也不排除其他因素导致HBsAg/HBcAg表达抑制。

Objective To investigate the differences in serum level of HBV DNA and the expression of HBsAg/HBcAg in the liver tissues between paitents with HBV-related hepatocellular carcinoma （HCC） and chronic hepatitis B （CHB）, and to explore the possible mechanism by which HBV infection causes HCC. Methods Eighty-nine HCC patients and 120 CHB patients were enrolled in the study. The serum level of HBV DNA was detected by quantitative real-time PCR. The expression of HBsAg/HBcAg in the liver tissues of HCC, paratumor liver cirrhosis （LC） and CHB was detected by immunohistochemistry. Results The serum level of HBV DNA in HCC patients was significantly lower than that in CHB patients （P〈O.05）. The positive rates of HBsAg were 90%, 51% and 10% in the liver tissues of CHB, paratumor LC and HCC. The positive rates of HBcAg were 78%, 19% and 3% in the above-mentioned tissues, respectively. Compared with the liver tissues of CHB and paratumor LC, HBsAg/HBcAg in the liver tissues of HCC decreased significantly （P〈0.05）. Conclusions The serum level of HBV DNA and the expression of HBsAg/HBcAg in liver tissues are significantly different during the different stages of chronic HBV infection. Compared with CHB patients, HCC patients have a relatively lower level of HBV DNA, and have a decreased expression of HBsAg/HBcAg or even lose their HBsAg/HBcAg, which may be associated with lower level of HBV DNA replication or the reduced expression of HBsAg/HBcAg caused by other factors.