肝癌自发性破裂与抗原抗体复合物的血管沉积

目的探讨肝癌自发性破裂的发病机理.方法肝癌破裂及非破裂病人的标本各30例,采用免疫荧光的方法,检查其血管壁上有无抗原抗体复合物的沉积.结果研究发现,肿瘤破裂的病人血管壁上有由乙肝病毒el抗原(HBeAg/1)、免疫球蛋白和补体C1q所组成的抗原抗体复合物的沉积,主要沉积在小动脉壁的弹力膜上.破裂组该复合物的血管壁沉积率为73%,非破裂组的仅01).结合既往的研究,证实在抗原抗体复合物的沉积处,其小动脉壁存在血管受损为12%(P＜0.0现象.结论抗原抗体复合物的沉积可造成血管损伤,致使病人的小动脉脆弱、受力情况下极易破裂出血,并可能是肝癌自发性破裂的病因之一.

Spontaneous rupture of hepatocellular carcinoma and deposition of antigen-antibody complex in vascular wall

Objective To study the pathogenesis of spontaneous rupture of hepatocellular carci- noma(HCC).Methods Specimens were collected from 30 patients with ruptured HCC and 30 with non-ruptured HCC.Using immunofluorescent technique,immune complex(IC)was tested in the specimens to find if it can deposite in the vascular wall.Results The IC consisting of HBV el antigen (HBeAg/1),eomplement Clq and immunoglobulins was found to be deposited in the elastic membrane of arteries.The rate of IC deposition was significantly higher in patients with ruptured HCC than in those with non-ruptured one(73% vs 12%,P<0.001).Vascular injury occurred mainly in the small arteries where the IC deposition was present.Since the small arteries were the blood vessels with pre- dominant injury,it is likely that they are ones to split and to cause hemorrhage and rupture of HCC during vascular load increase.Conclusions HBV infection and IC deposition in vascular wall resulting in vascular injury may be the factors involved in the pathogenesis of ruptured HCC.