HBV抗原对乙型肝炎相关性肝细胞癌分化程度的影响

Effect of HBV antigen to differentiation degree of HBV-associated hepatocellular carcinoma

目的探讨HBV抗原对乙型肝炎相关性肝细胞癌(HCC)病理分化程度的影响。方法收集乙型肝炎相关性HCC住院患者的HBV血清学、免疫组织化学及病理检测结果,输入SPSS21.00软件,计数资料的比较使用χ2检验和Fisher确切概率法进行统计分析。结果共收集到符合纳入标准的病例资料260例。其中HBsAg(+)、抗-HBe(+)、抗-HBc(+)血清标志物组合模式152例(58.5%),HCC中、低分化类型149例(57.3%)。HCC组织免疫组织化学检测HBsAg阳性206例(79.2%),其中HCC高分化类型5例(1.9%),中、低分化类型201例(77.3%);HCC组织免疫组织化学HBsAg阴性54例(20.8%),其中HCC高分化类型5例(1.9%);中、低分化类型49例(18.9%)。HCC组织免疫组织化学HBsAg阳性和HBsAg阴性在HCC高分化,中、低分化类型差异有统计学意义(P<0.05),乙型肝炎相关性HCC高分化和中、低分化与HCC组织中HBsAg呈负相关(r=-0.144,P<0.05)。乙型肝炎HBsAg(+)、抗-HBe(+)、抗-HBc(+),血清HBsAg,血清HBeAg及肝癌组织HBcAg对乙型肝炎相关性HCC高分化与中、低分化的影响差异均无统计学意义(P>0.05)。结论HBsAg在肝组织中存在的时间越长、水平越高,可能导致肝癌组织细胞的分化程度越低。

Objective To research the effect of the HBV antigen to the pathological differentiation degree of HBV-associated hepatocellular carcinoma(HCC).Methods The results of HBV serological,immunohistochemical and pathological examination in the patients with HBV-associated HCC were collected and input to the IBM SPSS21 software.The comparison of enumeration data conducted the statistical analysis by using the Chi-square test and Fisher exact probability method.Results A total of 260 cases of data conforming to the inclusion standard were collected.Among them,152 cases(58.5%)were the composite modes of serum HBsAg(+),HBeAb(+)and HBcAb(+),and 149 cases(57.3%)were the moderate and low differentiation type HCC.In the HCC immunohistochemistry detection,206 cases(79.2%)were HBsAg positive,among them,5 cases(1.9%)were the high differentiation type and 201 cases(77.3%)were the moderate and low differentiation type;54 cases(20.8%)were HBsAg negative in HCC immunohistochemistry,among them,5 cases(1.9%)were the HCC high differentiation type and 49 cases(18.9%)were the moderate and low differentiation type.In HCC immunohistochemistry,the HBsAg positive and HBsAg negative had statistical difference between the HCC high differentiation type with middle and low differentiation(P<0.05).The high differentiation with middle and low differentiation in HBV-associated HCC was negatively correlated with HBsAg in HCC tissue(r=0.144,P<0.05).The differences of influence of HBsAg(+),HBeAb(+),HBcAb(+),serum HBsAg,HBeAg and HCC tissue HBcAg on the high differentiation with middle and low differentiation of HBV-associated HCC had no statistical significance(P>0.05).Conclusion The longer existence and higher concentration of HBsAg in liver tissue can lead the lower differentiation degree of HBV-associated HCC.