慢性HBV携带者肝组织Fas和Fas配体表达变化及其意义

目的：观察慢性HBV携带者（chronic asymptomatic HBV carrier，ASC）肝组织Fas和Fas配体（FasL）的表达和血清可溶性Fas（sFas）水平的变化。方法对120例ASC行肝穿刺，采用免疫组织化学法检测肝组织Fas和FasL表达，采用ELISA法检测血清sFas水平。结果120例ASC肝组织完全正常者仅占11%，轻度肝炎占59%，而中、重度肝炎占30%；表现正常的肝组织无Fas和FasL表达，轻度肝炎肝组织多无表达或仅限于界面炎症区的肝细胞及淋巴细胞阳性表达，而中、重度肝炎肝组织Fas和FasL多为阳性，Fas强阳性率分别达34.8%和69.2%，FasL强阳性率分别达30.4%和53.8%，均明显高于正常组和轻度炎症组（P〈0.05），同时中、重度肝炎组间也存在显著性差异（P〈0.05），其分布除界面炎症区外，肝小叶中也弥漫分布；肝组织表现正常的ASC血清sFas水平为（1.68±0.33） ng/L，而轻、中、重度肝炎患者则分别为（2.58±0.31）ng/L、（3.94±0.21）ng/L和（5.94±0.26）ng/L，均较正常组显著升高（F=218.01，P〈0.01），各组间sFas水平也均具有统计学差异（P〈0.01）。结论 Fas和FasL介导的肝细胞凋亡在慢性HBV携带者肝组织病变中可能起到了重要作用。

Expression of Fas and Fa s ligand in liver tissues from chronic asymptomatic hepatitis B virus carriers

Objective To investigate the expression of Fas antigen and Fas ligand （FasL） in liver tissues from chronic asymptomatic hepatitis B virus （HBV） carrier （ASC）. Methods Liver biopsy specimen and sera from 120 individuals with ASC were obtained;The expression of Fas and FasL in liver tissues were detected by immunohistostaining. Serum levels of soluble Fas （sFas） and sFasL were measured by ELISA. Results Only 11%had a normal appearance of liver tissues in the 120 chronic HBV carriers,and 59% had mild and other 30% had moderate to severe hepatitis;Fas and FasL were negative in normal liver tissues,almost absent or only slightly pos-itive in hepatocytes and lymphocytes in inflammatory zone of the interface in liver tissues with mild hepatitis ,and strongly positive in those with moderate or severe hepatitis,showing a pattern of diffused staining in the interface area of hepatic lobules;The strongly positive rate for Fas and FasL in moderate （34.8% and 30.4%,respectively） and severe hepatitis （69.2% and 53.8%,respectively） was significantly higher than that in mild hepatitis or normal liver tissues（P〈0.05）;Serum sFas from persons with normal liver tissues was（1.68±0.33） ng/L,and they increased significantly to （2.58±0.31） ng/L,（3.94±0.21） ng/L and （5.94±0.26） ng/L,respectively,from individuals with mild, moderate and severe hepatitis （P〈0.01）. Conclusion The Fas-FasL mediated apoptosis might play an important role in the disease progress of ASC.