非肝病及慢性乙型肝炎患者肝组织中巨细胞病毒的检测

The detection of cytomegalovirus in liver tissues from patients without hepatitis and with chronic hepatitis B

目的 探讨巨细胞病毒 (CMV)在非肝病患者及慢性乙型肝炎患者肝组织中的表达、分布特点及相关关系。方法 采用免疫组化方法以抗 CMV单克隆抗体对 3 1例非肝病及 76例慢性乙型肝炎肝组织进行检测 ,用抗 HBcAg多克隆抗体和抗 CMV单克隆抗体双标记技术在部分慢性乙型肝炎患者同一张肝组织切片上显示两种病毒分布特点。结果 3 1例非肝病肝组织中检出CMVAg7例 (2 2 .6% ) ,明显低于慢性乙型肝炎患者 (4 3 /76,5 6.6% ) ,P <0 .0 1。在两组标本中CMVAg均在肝细胞胞浆内表达。非肝病患者肝组织中阳性细胞数量较慢性乙型肝炎患者少 ,后者阳性细胞多近汇管区分布 ,数量多时 ,也可在肝小叶内弥漫分布。轻度和重度慢性乙型肝炎患者中CMV的检出率比较 ,差异无显著性 ,但重度慢性乙型肝炎患者中CMV表达阳性细胞明显多于轻度慢性乙型肝炎 (P <0 .0 5 )。双标记染色显示CMVAg和HBcAg多数可表达于肝小叶内同一区域肝细胞甚至同一肝细胞内 ,也可见于肝小叶中不同部位。结论 非肝病患者中CMV感染并不少见 ,慢性乙型肝炎患者更易重叠CMV感染 ,并且其感染程度与肝组织的活动性病变密切相关。

Objective To explore the cytomegalovirus antigen (CMV?Ag) expression and distribution in the liver tissue of patients without hepatitis and super infected with hepatitis B virus as well as the relationship between CMV and HBV.Methods The liver tissues from 31 cases without hepatitis and 76 cases with chronic hepatitis(including 44 cases with mild and 32 cases with marked chronic hepatitis) were detected by immunohistochemical staining with monoclonal anti CMV?Ag, and part of cases with positive HBcAg were studied by double labeling techniques using polyclonal anti HBc and monoclonal anti CMV.Results The total positive rate of CMV?Ag was 22.6% in patients without hepatitis and lower than in patients with chronic hepatitis B(56.6%, P <0.01). CMV?Ag was mainly found in the cytoplasm of hepatocytes, The CMV?Ag positive cells were less in the patients without hepatitis than those with chronic hepatitis B. The distribution of CMV?Ag positive cells in the cases with hepatitis B virus might be aggregated near periportal areas or scattered in intralabular. There was no significant difference of positive rates between mild and marked chronic hepatitis cases, but the number of CMV?Ag positive cells was less in the former than in the latter( P <0.05). Double labeling studies showed that both of CMV?Ag and HBcAg might mainly expressed in the same area of the liver even in the same hepatocyte in most cases, but also in different intralabular.Conclusion CMV infection in the patients without hepatitis is not rare to be seen. Cytomegalovirus is more frequently superinfected in the patient with chronic hepatitis B, and the degree of CMV infection is closely associated with liver inflammation.