ABO血型与PHC患者HBV感染标记相关性研究

研究伴ＨＢＶ感染的ＰＨＣ４４５例乙型肝炎抗原抗体与ＡＢＯ血型的关系，结果表明：１．伴ＨＢＶ感染的ＰＨＣＡ型血者显著高于对照组（Ｐ＜０．０１）。２．ＰＨＣ患者中ＨＢｓＡｇ、抗－ＨＢｃ的阳性率均以Ａ型血显著高于对照组（Ｐ＜０．０５）。３．ＰＨＣ患者中ＨＢｓＡｇ与抗－ＨＢｃ均阳性模式Ａ型血者显著多于对照组，而Ｂ型血者显著少（Ｐ＜０．０５）；抗－ＨＢｅ与抗ＨＢｃ均阳性的ＰＨＣ中，亦为Ａ型血者显著多（Ｐ＜０．０５）。提示有ＨＢＶ感染的Ａ型血者罹患ＰＨＣ的倾向性最高；而有ＨＢＶＭ、ＨＢｓＡｇ、抗－ＨＢｃ的Ａ型血者则为ＰＨＣ的易感人群，其中以ＨＢｓＡｇ和抗－ＨＢｃ同时阳性或抗－ＨＢｅ和抗－ＨＢｃ同时阳性的感染模式更易发生ＰＨＣ；也提示ＰＨＣ、ＨＢＶ、Ａ型血三者之间存在某种密切的、复杂的联系，对ＰＨＣ的发生有协同作用。对上述人群应密切关注，定期复查，以期早诊早治。     

肝癌患者一级亲属HBV感染的调查分析

本文从ＨＢＶ感染的角度研究肝癌家族内的遗传效应。结果表明：１，原发性肝癌（ＰＨＣ）患者一级亲属２２７人。其乙型肝炎病毒感染标记（ＨＢＶＭ）阳性率为７１．８１％，ＨＢｓＡｇ阳性率为４２．７３％，显著高于当地的自然人群（Ｐ＜０．０５）；其ＨＢＶＭ最常见模式是ＨＢｓＡｇ、抗－ＨＢｅ和抗－ＨＢｃ同时阳性，与有ＨＢＶ感染的ＰＨＣ患者ＨＢＶＭ的最常见模式相一致。２．患者同胞的ＨＢＶＭ阳性率为８２，９８％，ＨＢｓＡｇ为５１．０％，均显著高于患者双亲、子代（Ｐ＜０．０５）；且男性显著多于女性（Ｐ＜０．０５）。３．患者母亲组的ＨＢＶＭ明显高于父亲组（＋３１．４３％）。提示ＰＨＣ患者一级亲属确是一组ＨＢＶ易感人群，且肝癌家族内ＨＢＶ感染、ＰＨＣ都呈明显的、以母系亲代传递为特征的家族聚集现象；ＨＢＶ经垂直感染可导致家族性ＰＨＣ，ＰＨＣ患者同胞（尤其男性）是ＨＢＶ、ＰＨＣ最易感人群。因此，对该人群需密切关注，定期复查，警惕ＰＨＣ的发生。     

肝癌,肝硬变患者的戊型肝炎病毒感染

目的研究肝癌和肝硬变患者的肝炎病毒感染情况。方法用酶联免疫吸附测定（ＥＬＩＳＡ）法测定患者血清中的乙型肝炎病毒表面抗原（ＨＢｓＡｇ）、丙型肝炎病毒抗体（抗ＨＣＶ）和戊型肝炎病毒抗体（抗ＨＥＶ）。结果肝癌患者中抗ＨＥＶ阳性率为５８．９％（６３／１０７），ＨＢｓＡｇ阳性率为６９．２％（７４／１０７），抗ＨＣＶ阳性率为１０．３％（１１／１０７），肝硬变患者的阳性率依次为６３．０％（１７／２７）、７４．１％（２０／２７）、７．４％（２／２７）。只有抗ＨＥＶ阳性而ＨＢｓＡｇ和抗ＨＣＶ阴性的肝癌患者有１３例（１２．２％）。仅ＨＢｓＡｇ阳性而抗ＨＥＶ和抗ＨＣＶ阴性的有２４例（２２．４％），仅抗ＨＣＶ阳性而抗ＨＥＶ和ＨＢｓＡｇ阴性的有３例（２．８％）。全部阴性的有１０例（９．４％）。肝硬变患者中仅抗ＨＥＶ阳性而抗ＨＣＶ和ＨＢｓＡｇ阴性的有５例（１８．５％），仅ＨＢｓＡｇ阳性而抗ＨＥＶ和抗ＨＣＶ阴性的有９例（３３．３％），全部阴性的有１例（３．７％）。结论除ＨＢＶ和ＨＣＶ外，ＨＥＶ感染似乎在肝癌变及肝硬变中也起着一定的作用     

广州地区肝细胞癌与HCV,HBV感染关系的病例对照研究

在肝细胞癌（ＨＣＣ）中度流行区广州地区，对６４例ＨＣＣ患者抗－ＨＣＶ和ＨＢｓＡｇ状况按性别、年龄配对和１：２数量比设对照组进行了病例对照研究。结果表明：ＨＣＣ组抗－ＨＣＶ和ＨＢｓＡｇ阳性率分别为１８．７５％（１２／６４）和８４．３８％（５４／６４），分别显著高于对照组的２．３４％（３／１２８，Ｐ＜０．００１）和１４．０６％（１８／１２８，Ｐ＜０．００１）。与抗－ＨＣＶ、ＨＢｓＡｇ双阴性组比较，仅抗－ＨＣＶ阳性，仅ＨＢｓＡｇ阳性时发生ＨＣＣ的相对危险度分别为４６．７１和４３．７９，二者双阳性时上升至７０．０７。显示ＨＣＶ、ＨＢＶ均与ＨＣＣ显著相关，两者重叠感染具有协同致癌作用。作者提出预防和控制ＨＢＶ、ＨＣＶ感染对降低ＨＣＣ发病率意义重大。     

原发性肝癌与乙型肝炎病毒感染血清学标记的关系

为了探讨原发性肝癌（ＰＨＣ）患者血清乙型肝炎病毒（ＨＢＶ）感染标志在各年龄组间的差异，采用酶联免疫法（ＥＬＩＳＡ）检测了２２１例住院病人的血清ＨＢＶ五项标志，结果发现ＨＢＶ感染率在各年龄组均呈高值，证实了ＨＢＶ感染是ＰＨＣ的一个重要致病因素，尤其是ｅ抗原系统，ＰＨＣ患者ＨＢｅＡｇ阳性率其年龄分布，３０岁以后随年龄增长而下降，６０岁以后明显下降，差异均有显著性（Ｐ〈０．０５），３０岁～４０岁组年龄组     

原发性肝癌组织中Fas和FasL的表达研究

为了探讨原发性肝癌组织中乙肝病毒和丙肝病毒的感染与Ｆａｓ 和ＦａｓＬ表达的关系,采用免疫组化方法观察４０ 例原发性肝癌组织中Ｆａｓ、ＦａｓＬ、ＨＢｓＡｇ 及ＨＣＶ 抗原（ＮＳ５） 的表达。结果显示：癌细胞Ｆａｓ 阳性７ 例,阳性率为１７．５％ ,ＦａｓＬ阳性６例,阳性率为１５．０％ ;癌旁肝细胞Ｆａｓ 阳性２１ 例,阳性率５２ ．５％ ,ＦａｓＬ阳性１８ 例,阳性率４５ ．０％ 。癌组织中ＨＢｓＡｇ 阳性１２ 例,阳性率为３０．０％ ;癌旁组织中２５ 例阳性,阳性率为６２ ．５％ 。１２ 例ＨＢｓＡｇ 阳性的癌组织中,Ｆａｓ 阳性６ 例,ＦａｓＬ阳性５ 例;２８ 例ＨＢｓＡｇ 阴性的癌组织中,Ｆａｓ 和ＦａｓＬ 阳性各１ 例;癌组织中ＨＣＶＮＳ５ 阳性１１ 例,阳性率为２７ ．５ ％ ,癌旁组织中其阳性率为１２ ．５％（５／４０） ,１１ 例ＨＣＶＮＳ５ 阳性的肝癌组织中,Ｆａｓ 和ＦａｓＬ 阳性各５ 例,２９ 例ＨＣＶＮＳ５ 阴性的肝癌组织中,Ｆａｓ 阳性２ 例,ＦａｓＬ阳性１ 例。２ 组比较有显著性差异（ Ｐ＜０ ．０５） 。结果表明肝癌组织中Ｆａｓ 和ＦａｓＬ的表达与ＨＢＶ 和ＨＣＶ 的感染有一定关系。癌旁肝组织Ｆａｓ 和ＦａｓＬ高表达的意义尚不清楚     

原发性肝癌患者血清中庚型肝炎病毒基因的检测

用逆转录－聚合酶链反应法（ＰＴ－ＰＣＲ）检测了６７例原发性肝癌（ＰＬＣ）患者血清中的庚型肝炎病毒（ＨＧＶ）ＲＮＡ，以ＰＣＲ－双脱氧末端终止法分析了ＰＣＲ产物的核苷酸序列。结果显示，ＨＧＶＲＮＡ的检出率为１９．４％（１３／６７），其在ＨＢｓＡｇ阳性组和ＨＢｓＡｇ／抗ＨＣＶ阴性组中的阳性率分别是１２．２％（６／４９）和５０％（７／１４）；５’非编码区（５’－ＮＣＲ）扩增片段的核苷酸序列与美国株ＧＢＶ－Ｃ的同源性为９１．７％，提示在我国ＰＬＣ患者中存在ＨＧＶ感染。     

丙型肝炎病毒核心抗原及HBxAg在肝硬化、肝细胞肝癌中分布的免疫组化研究

研究丙型肝炎病毒核心抗原在肝硬变、肝细胞肝癌中的分布规律及意义。方法以免疫组织化学方法检测丙型肝炎病毒（ｈｅｐａｔｉｔｉｓＣｖｉｒｕｓ，ＨＣＶ）核心抗原及ＨＢｘＡｇ在肝硬化、肝细胞癌及其癌旁肝组织中的定位及分布。结果ＨＣＶ核心抗原既定位于肝细胞或癌细胞胞核中，又可定位于这些细胞的胞浆中。在不同的病例，有时以胞浆阳性为主，有时以胞核阳性为主，或二者同时存在。肝硬化组织中，ＨＣＶ核心抗原胞浆阳性细胞多呈灶性分布，而核阳性病例阳性细胞则为弥漫分布；肝细胞肝癌中ＨＣＶ核心抗原以弥漫胞核阳性多见，癌旁肝组织多为ＨＣＶ核心抗原胞浆阳性。ＨＣＶ核心抗原在肝硬化、肝细胞肝癌及癌旁肝中的阳性率分别为６７．３％（６６／９８），７５．０％（７８／１０４）及４８．１％（２５／５２），χ２检验，肝细胞癌中核心抗原的胞核阳性率明显高于其在肝硬化及癌旁肝中的胞核阳性率（Ｐ＜０．０１）。核心抗原在肝细胞肝癌中，其细胞核阳性率，明显高于细胞浆阳性率（Ｐ＜０．０１）。结论ＨＣＶ感染在我国肝硬化、肝细胞肝癌中比较普遍，除ＨＢＶ以外，ＨＣＶ可能在我国肝硬化、肝细胞癌的发生中起着重要作用     

HBV,HCV在原发性肝癌发生中的相互作用研究

为了解河南省原发性肝癌（ＰＨＣ）发生中ＨＢＶ、ＨＣＶ的相互作用，我们应用ＥＬＩＳＡ法和ＰＣＲ法对ＰＨＣ患者及其１：１对照进行了ＨＢＶ标志物（ＨＢＶＭ）和ＨＣＶ标志物（ＨＣＶＭ）检测。结果：ＰＨＣ患者ＨＢＶＭ阳性率为８１．２５％，对照组ＨＢＶＭ阳性率为９．６０％，Ｐ〈０．０１，ＯＲ＝７０（２５．３６，１９３．２３）；ＰＨＣ患者ＨＣＶＭ阳性率为１９．７９％，对照组ＨＣＶＭ阳性率为８．３３％，Ｐ〈０．０     

原发性肝癌丙肝病毒基因及其抗体的检测

本文报道运用巢式ＰＣＲ，ＥＬＩＳＡ等方法检测我国原发性肝癌，癌旁组织和外周血中ＨＣＶ－ＲＮＡ抗－ＨＣＶ，同时监测了ＨＢｓＡｇ。所用引物位于ＨＣＶ基因５＇－端非编码区域。结果７６例肝癌病人血清中抗－ＨＣＶ阳性９．２％（７／７６），ＨＣＶ－ＲＮＡ阳性１３．２％（１０／７６）；３４例肝癌组织中ＨＣＶ－ＲＮＡ阳性１１．８％（４／３４），１例抗ＨＣＶ阴性的病人在癌及癌旁组织中检测到ＨＣＶ－ＲＮＡ，提示我国Ｈ     

青少年原发性肝癌与乙型和丙型肝炎病毒感染的相关性分析

目的探讨青少年原发性肝癌(PHC)患者中乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)及HBV和HCV混合感染率及其相互关系。方法将50例青少年PHC患者纳入观察组,将同期住院的50例其他肝病患者纳入对照组,检测两组患者血清中HBV、HCV、HBV/HCV标志物阳性率等情况。结果观察组患者血清中HBsAg、抗Hbe和HBV-DNA阳性率均显著高于对照组患者,差异有统计学意义(P<0.05)。两组患者血清中HBeAg阳性率比较,差异无统计学意义(P>0.05)。观察组和对照组患者血清中抗HCV和HCV-RNA阳性率比较,差异无统计学意义(P>0.05);HBV(+)HCV(+)和HBV(+)HCV(-)与青少年PHC发病呈正相关性(P<0.05),HBV(-)HCV(+)与青少年PHC发病无相关性(P>0.05),HBV(-)HCV(-)与青少年PHC发病呈负相关性(P<0.05)。结论 HBV感染与青少年PHC发病有着较强的相关性,属高度危险因素。     

乙型肝炎病毒感染与B细胞型非霍奇金淋巴瘤的关系．

目的探讨B细胞型非霍奇金淋巴瘤（NHL）与乙型肝炎病毒（HBV）之间的关系。方法统计2003年1月至2009年12月住院的284例B细胞型NHL患者的乙肝5项标志物阳性率,并与同期住院的大肠癌患者作比较。结果B细胞型NHL以18—39岁和Ⅲ一Ⅳ期患者乙型肝炎表面抗原（HBsAg）阳性率较高,分别为42．6％（26／61）和37．0％（50／135）,分别与其他年龄段及I一Ⅱ期患者比较,差异均有统计学意义（x。值分别为7．573和6．874,P值分别为0．023和0．009）;B细胞型NHL患者HBsAg、乙型肝炎e抗原（HBeAg）的阳性率较大肠癌患者高[29．6％（84／284）比14．5％（155／1070）,6．7％（19／284）比0．8％（9／1070）,Wald值分别为25．174和20．496,P值均为0．0011;乙型肝炎表面抗体（抗HBsAb）阳性率较大肠癌患者低『45．4％（129／284）比58．0％（621／1070）,waid=11．062,P=0．0011;HBsAg、HBeAg及乙型肝炎核心抗体（抗HBcAb）同时阳性和HBsAg、乙型肝炎e抗体（抗HBeAb）及抗HBcAb同时阳性的发生率较大肠癌患者高『6．0％（17／284）比0．8％（9／1070）,16-2％（46／284）比11．5％（123／1070）,x0值分别为31．619和4．542,P值分别为0．000和0．033];抗HBcAb阳性且抗HBsAb阴性的发生率也较大肠癌患者高[37．0％（105／284）比24．5％（262／1070）,Wald=17．708,P〈0．001];抗HBcAb和抗HBsAb同时阳性的发生率较大肠癌患者低『20．8％（59／284）比27．8％（297／1070）,Wald=5．646,P=0．017]。结论HBV感染和B细胞型NHL存在一定相关性,HBV感染可能在B细胞型NHL的病原学中起作用。     

HBV感染与原发性肝细胞癌的关系及临床意义

目的 探讨乙型肝炎病毒(HBV)感染与原发性肝细胞癌(PHC)的关系及临床意义.方法 选取240例PHC患者作为PHC组,480例健康体检者作为对照组,检测并分析两组研究对象的HBV感染情况,并采用多因素分析法探讨HBV感染与原发性肝细胞癌的关系.结果 PHC组患者的HBV感染阳性率、HBsAg阳性率、HBeAg阳性率、抗HBe阳性率、抗HBc阳性率均明显高于对照组(P﹤0.01),抗HBs阳性率明显低于对照组,差异均有统计学意义(P﹤0.01);经非条件Logistic回归分析结果显示:有PHC家族史、有饮酒史、合并HBV感染是发生PHC的独立危险因素(P﹤0.05).结论 PHC的发病风险由多种因素导致,其中,HBV感染是其重要的发病原因之一.     

Viral hepatitis (HBV and HCV) background in Chinese patients with hepatocellular carcinoma

Antibody to hepatitis C virus (Anti-HCV) was detected using anti-HCV EIA (Abbott Kit) in the sera of Chinese patients with hepatocellular carcinoma (HCC), acute hepatitis, chronic hepatitis and blood donors, the positive rates being 10.4% (61/586), 11.8% (10/85), 19.2% (44/229), and 1.9% (3/160) respectively. HBV DNA was detected by polymerase chain reaction (PCR) in sera from 61 HCC patients with positive anti-HCV, the positive rate for HBV DNA being 55.7% (34/61), which was lower than those with negative anti-HCV (78.7%, 413/525). These results indicate that in China the role of HBV infection in the causation of HCC seems to be more important than that of HCV infection. This paper is one of the symposium papers on primary liver cancer research (Chin J Cancer Res 6(1), 1994)     

Primary hepatocellular carcinoma in intertropical Africa: relationship between age and hepatitis B virus etiology

Clinical observations of patients with primary hepatocellular carcinoma (PHC) at Le Dantec Hospital, Dakar, Senegal, were studied to determine a correlation with hepatitis B virus (HBV) infection. Of the 103 patients with PHC, 80 had an active HBV infection (HBsAg and/or anti-HBc); 23 showed signs of previous HBV infection (anti-HBs and anti-HBc). The two groups were similar in the detection of alpha-fetoprotein (approximately 60%) and in the major clinical findings: hepatomegaly, 76.25% and 86.96%, respectively; and ascites, 57.50% and 47.83%, respectively. Jaundice, however, was three times more frequent (P < 0.01) in the group of patients with signs of active HBV replication. Distribution of HBV markers as a function of age at onset of PHC revealed that the presence of HBsAg was primarily confined to the sera of the younger patients (< 50 yr old). When compared with leprosy patients and blood donors, the younger PHC patients differed in the frequency of detection of HBsAg and anti-HBs. The older people (> 50 yr old) in the three groups (PHC patients, leprosy patients, and blood donors) had identical HBV markers.     

肝硬变和肝癌组织内HCV RNA及HBV X基因的存在及意义

采用原位分子杂交对７９例肝硬变及６４例肝细胞癌组织进行ＨＣＶ ＲＮＡ和ＨＢＶ Ｘ基因定位检测，ＨＣＶ ＲＮＡ，ＨＶＢ Ｘ基因在两种组织的阳性率分别是４８％及７２％；３９％，及８１％；二者同时阳性在两种组织分别为３８％及３３％。ＨＣＶ ＲＮＡ主要定位于肝细胞和癌细胞胞浆内，阳性细胞呈散在、灶状及弥漫分布三种形式。ＨＢＶ Ｘ基因在肝细胞及肝癌细胞中的分布呈胞浆型、核型及核浆型，阳性细胞也呈上述三种分布     

Hepatitis B virus infection and primary hepatocellular carcinoma.

Ninety-three patients with biopsy-proven primary hepatocellular carcinoma (PHC) from Uganda, Zambia, and the United States were examined for serologic evidence of hepatitis B virus (HBV) infection. Patients were tested for hepatitis B surface antigen (HBsAg) and its antibody (anti-HBs), antibody to the hepatitis B core antigen (anti-HBc), hepatitis B e antigen (HBeAg), and its antibody (anti-HBe). Active HBV infection, as indicated by positive tests for HBsAg (with or without anti-HBs) and anti-HBc (without anti-HBs), was present in 62% of PHC patients (58 of 93), in contrast with 10% of African controls (9 of 90), and less than 1% of most United States adult populations reported in the literature. The presence of HBeAg or anti-HBe was rare among PHC patients and controls.     

Hepatitis C virus infection in patients with essential mixed cryoglobulinemia, multiple myeloma and chronic lymphocytic leukemia

Increased prevalence of HCV infection in some lymphoproliferative diseases has been recently reported. In the present study, the frequency of anti-HCV antibody (Ab) together with hepatitis B surface (HBs) antigen (Ag) and anti-HBs Ab were determined in 42, 45 and 23 patients with essential mixed cryoglobulinemia (EMC), multiple myeloma (MM) and B-cell chronic lymphocytic leukemia (B-CLL), respectively. Thirty hospitalized patients with chronic rheumatoid arthritis (RA) were also included as a control. Specific antibodies to HCV antigens were detected by enzyme linked immunosorbent assay (ELISA) and positive results were confirmed by a recombinant immunoblot assay (RIBA). Our results demonstrated anti-HCV positivity in 69%, 11% and 4.3% of the EMC, MM and B-CLL samples tested, respectively. None of the RA patients were found to be anti-HCV positive. No significant differences were observed between the patients groups regarding the frequency of HBs Ag and anti-HBs Ab. Considering the low incidence of HCV infection in the control group and the normal population, these results confirm and extend previous reports on the possible role of HCV infection in the etiology of EMC and further suggest involvement of this virus in a subset of MM.     

Hepatitis B viral markers in patients with primary hepatocellular carcinoma in Taiwan

The presence of hepatitis B viral markers in patients with primary hepatocellular carcinoma (PHC) was studied retrospectively at the Taiwan Veterans General Hospital in Taipei, Taiwan. Serum samples from 102 PHC patients and from 100 control individuals were tested for hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs), antibody to hepatitis B core antigen (anti-HBc), hepatitis Be antigen (HBeAg), and antibody to HBeAg (anti-HBe). Of the 102 PHC patients, 72 (71%) were positive for HBsAg. Nine (9%) additional patients were positive for anti-HBc alone in high titer, 19 (19%) had both anti-HBc and anti-HBs, and 9 (9%) had HBsAg, anti-HBc, and anti-HBs. In the 100 controls, 12 (12%) were HBsAg-positive, whereas 22 (22%) had anti-HBc alone and 50 (50%) had both anti-HBc and anti-HBs. Only 4 (4%) controls and no PHC patients had anti-HBs alone. Of the HBsAg-positive patients with PHC, 17 (29%) had HBeAg and 36 (61%) had anti-HBe. The alpha-fetoprotein (AFP) levels above 400 ng/ml were found in 44% of the PHC patients. Values of AFP above 1 x 10(5) ng/ml were more frequently detected in PHC patients who were HBsAg-positive. Categorization of the geographic origins of the families whose members had PHC revealed that most families had originated from southern China. This study confirms that hepatitis B viral markers are frequently present in Chinese patients with PHC.