肝细胞癌血清、肝组织中HCV和HBV感染状况的研究

The HCV and HBV infection in the patients with hepatocellular carcinoma ─A study on sera and hepatic tissue

目的 :通过研究肝细胞肝癌患者血清和肝组织中乙型、丙型肝炎病毒感染状况 ,探讨丙型肝炎病毒与肝细胞癌发生的关系。方法 :采用ELISA法检测 12 6例肝细胞癌患者血清中的抗 -HCV、乙肝两对半 ,采用套式PCR检测血清中HCVRNA、HBVDNA以及组织标本中的HCVRNA、HBVDNA。结果 :12 6例HCC患者血清中抗 -HCV阳性率为 11 1% ,HCVRNA阳性率为 17 5 % ,抗 -HCV和HCVRNA同时联合检测HCV的阳性率为 2 1 4 % ,血清HBsAg阳性率为 82 5 % ,HBVDNA的阳性率为 75 4 % ,HBsAg和HBVDNA联合检测同时HBV阳性率为 92 9% ,HBV、HCV重叠感染率为 17 5 % ,肝癌和癌旁组织HCVRNA和HBVDNA的阳性率分别为 7 9%、12 7%和 3 8 1%、74 6%。结论 :利用PCR技术直接检测HCVRNA和ELISA法检测抗 -HCV更能全面了解和准确评价HCV在HCC患者中的感染情况 ,肝癌患者的癌旁组织和癌组织中都检测到HCVRNA ,提示HCV在肝组织中的存在及复制 。

Objective:To detemine the infection of HBV and HCV and evaluate the relationship between HCV infection and the development of HCC. Method:Analysis on 126 patients with HCC was done. The technique of ELISA was used to detect the anti-HCV and HBsAg of the sera . And the technique of PCR was used to detect the HBV DNA and HCV RNA of the sera and hepatic tissue. Results:The positive rate of anti-HCV in the patients with HCC in this area was 11.1%(14/126).The positive rate of HCV RNA was 17.5%(22/126). If HCV infection was defined as anti-HCV and or HCV RNA positive, the infective rate of HCV was 21.4%in this study. The positive rate of HBsAg and HBV DNA were 82.5%(104/126)and 75.4%(95/126). The infective rate of HBV by combining detection of HBV RNA and HBsAg was 92.9%(117/126). The overlapping HCV and HBV infective rate was 17.5%(22/126). We detected the HCV RNA and HBV DNA in hepatic tissue, the positive rate of HCV RNA in cancerous and pericancerous tissue were 7.9%(10/126)and 12.7%(16/126) respectively, and the HBV RNA positive rate were 38.1%(48/126) and 74.6%(94/126).Conclusions:HCV infection in the patients with HCC was determined more accurate by combining detection of HCV RNA and anti-HCV. This results suggested the presence and replication of HCV and HBV inside the hepatic tissue, and indicated both HCV and HBV might be the important factors in the development of HCC.