肝组织HBsAg、HBcAg和血清HBsAg水平、HBV DNA载量与肝组织病理学相关性

Correlations of hepatic HBsAg,HBcAg levels in liver tissue and serum HBsAg,HBV DNA levels with pathological grading and staging of histology in patients with chronic hepatitis B

目的探讨慢性乙型肝炎肝组织HBsAg、HBcAg表达水平和血清HBsAg水平、HBV DNA载量与肝组织病理学分级和分期之间的相关性。方法慢性乙型肝炎患者388例,其中HBeAg阳性196例,HBeAg阴性192例,均经肝活组织检查。采用Abbott Architect I2000及其配套试剂检测血清HBsAg和HBeAg,实时荧光定量PCR检测血清HBV DNA,采用免疫组织化学法检测肝组织HBsAg、HBcAg。统计分析采用SPSS 16.0软件。结果 HBeAg阳性患者血清HBsAg水平与病理学分级和分期均呈显著负相关(P<0.01),血清HBV DNA载量与病理学分级和分期均无显著相关性(P>0.05);HBeAg阴性患者血清HBsAg水平与病理学分级和分期均无显著相关性(P>0.05),血清HBV DNA载量与病理学分级和分期均呈显著正相关(P<0.01)。HBeAg阳性患者肝组织HBsAg表达水平与病理学分级和分期均无显著相关性(P>0.05),HBcAg表达水平与病理学分级和分期均呈显著负相关(P<0.05);HBeAg阴性患者肝组织HBsAg表达水平与病理学分级和分期均无显著相关性(P>0.05),HBcAg表达水平与病理学分级呈显著正相关(P<0.01),与病理学分期无显著相关性(P>0.05)。结论在HBeAg阳性阶段,血清HBsAg水平和肝组织HBcAg水平的逐步下降与肝组织炎症活动度和纤维化程度的进行性加重有关;在HBeAg阴性阶段,血清HBV DNA载量和肝组织HBcAg水平的升高与肝组织炎症活动度和纤维化程度的加重有关。

Objective To explore the correlations of HBsAg,HBcAg expression levels in liver tissue and serum HBsAg,HBV DNA levels with pathological grading and staging of histology in patients with chronic hepatitis B （CHB）. Methods Three hundred and eighty-eight patients with liver biopsies were enrolled in present study,including 196 HBeAg-positive patients and 192 HBeAg-negative patients.Serum HBsAg and HBV DNA level were determined by Abbott Architect I2000 and polymerase chain reaction （PCR）,respectively,and hepatic HBsAg and HBcAg expressions were measured by immunohistochemistry.SPSS 16.0 software was used for statistical analyses.Results In HBeAg-positive patients,serum HBsAg levels were significantly negatively correlated with both pathological grading and staging of liver tissues （P ＆lt;0.01 ）,while serum HBV-DNA levels were correlated with neither pathological grading nor staging of liver tissues （P ＆gt;0.05 ）;in HBeAg-negative patients,serum HBsAg levels were not correlated with pathological grading and staging of liver tissues （P ＆gt; 0.05 ）,while serum HBV DNA levels were significantly positively correlated with both pathological grading and staging of liver tissues （P ＆lt;0.01）.In HBeAg-positive patients,there was no correlation between hepatic HBsAg expression levels and either pathological grading or staging of liver tissues （P ＆gt;0.05）,while hepatic HBcAg expression levels showed a significantly negative correlation with both pathological grading and staging of liver tissues （P ＆lt;0.05 ）;in HBeAg-negative patients,hepatic HBsAg expression levels were not correlated with pathological grading or staging of liver tissues （P ＆gt;0.05 ）,while hepatic HBcAg expression levels were significantly positively correlated with pathological grading （P ＆lt;0.01）but were not correlated with pathological staging （P ＆gt;0.05）of liver tissues.Conclusion The aggravations of inflammatory activities and fibrotic levels of liver tissues are correlated with the gradual decline of serum HBsAg levels and hepatic HBcAg expression levels in HBeAg-positive patients with CHB,and the increase of serum HBVDNA l and hepatic HBcAg expression levels in HBeAg-negative patients with CHB.