3-磷酸甘油酸脱氢酶及其抗体对自身免疫性肝炎的诊断意义

目的 克隆D-3-磷酸甘油酸脱氢酶(Phgdh)的cDNA,构建重组表达质粒,纯化重组蛋白,初步探讨Phgdh抗体在自身免疫性肝炎诊断中的意义. 方法血清蛋白质组学方法鉴定差异蛋白,构建重组表达载体,在大肠杆菌中表达,融合蛋白经Ni-NTA树脂柱亲和层析纯化,通过十二烷基硫酸钠聚丙烯酰胺凝胶电泳及Western blot法进行免疫鉴定;应用表达蛋白建立间接酶联免疫吸附法,检测60名健康体检者、65例自身免疫性肝炎(AIH)、122例原发性胆汁性肝硬化、56例慢性乙型肝炎,117例慢性丙型肝炎患者血清中抗Phgdh抗体.组间率的比较用χ2检验.结果 经重组质粒测序和酶切鉴定结果证实,Phgdh目的 基因已正确插入原核表达载体中,基因序列正确,符合表达框架.十二烷基硫酸钠聚丙烯酰胺凝胶电泳检测表达产物在相对分子质量约6.0×104附近有一明显的蛋白表达带,Western blot分析结果显示重组蛋白具有Phgdh抗原反应性.酶联免疫吸附法检测血清标本结果显示,AIH、原发性胆汁性肝硬化、慢性乙型肝炎、慢性丙型肝炎及正常人抗Phgdh抗体阳性检出率分别为66.15%、21.42%、12.50%、6.83%和3.30%.AIH组Phgdh自身抗体阳性率与疾病对照组及正常对照组比较,差异均具有统计学意义(P<0.01).结论 本研究成功克隆了Phgdh的cDNA,并将其在大肠杆菌中成功表达.该抗体主要在AIH患者中检出,此抗体的检测有助于提高AIH的临床诊断水平.     

乙型肝炎病毒cccDNA与HBx蛋白在肝细胞性肝癌中表达的关系及意义

目的:探讨肝细胞性肝癌中乙型肝炎病毒(HBV)occDNA与HBx蛋白表达的关系及其意义.方法:取42例肝细胞性肝癌患者的癌和癌旁组织,采用SABC法检测组织中的HBx蛋白;采用RT-PCR法检测组织中的HBV CCCDNA水平.结果:HBx蛋白在癌及癌旁组织中的阳性例数分别为31例(73.8%)和35例(83.3%),无显著性差异;癌旁组织中cccDNA水平较癌组织中的高,但是统计学检验无显著性差异;癌组织和癌旁组织中HBx蛋白(+)者的cccDNA水平均明显高于HBx蛋白(-)者(P＜0.05).HBx蛋白表达与cccDNA水平呈正相关(r=0.778,P＜0.01).结论:HBx蛋白的表达与cccDNA水平明显相关,他们相互作用、相互影响并在肝癌的发生发展中起重要作用.     

慢病毒介导HBV X基因稳定表达HepG2细胞系的建立

目的:构建乙型肝炎病毒X基因(HBV X)重组慢病毒表达载体,建立稳定表达HBVX蛋白(HBx)的HepG2细胞系.方法:应用PCR法从质粒pIERES2-EGFP-HBV中扩增X基因片段,克隆至慢病毒载体pZac2.1,应用PCR、酶切和测序鉴定正确后,经病毒包装,感染HepG2细胞,经嘌呤霉素筛选稳定表达细胞株,RT-PCR、免疫组织化学、Western blot鉴定HBx的表达.结果:酶切鉴定和基因序列测定证实长度为489bp的HBx基因成功克隆至慢病毒表达载体pZac2.1-HBx;重组慢病毒经包装、纯化后获得滴度为1×108TU/mL,通过感染HepG2细胞株和嘌呤霉素筛选,8-10d形成生长形态良好的单克隆细胞株HepG2-HBx;RT-PCR鉴定显示细胞株HepG2-HBx在3d,14d,30d和2mo后均可见稳定表达的HBx mRNA;利用免疫组织化学和蛋白免疫印迹法鉴定,细胞株HepG2-HBx可稳定表达HBx蛋白.结论:成功构建了HBV X重组慢病毒载体,获得稳定表达HBx的HepG2细胞系,为进一步研究HBx的生物学功能及致病机制提供细胞模型.     

过表达HBx的肝细胞对肝星状细胞增殖和活化的影响及其机制

目的探讨HBV感染对肝星状细胞(HSC)活化的影响及作用机制。方法收集2020年11月—2021年1月慢性乙型肝炎患者血浆30份、乙型肝炎肝硬化患者血浆42份、肝细胞癌患者血浆30份及健康体检者(健康对照组)的血浆18份,ELISA法检测血浆和条件培养液中HBx、TGFβ1、多巴胺β羟化酶(DBH)和羟脯氨酸(Hyp)的含量。采用LO2细胞构建过表达HBx稳转株细胞,LO2细胞分为LO2-HBx组(稳定表达HBx)、阴性对照组(LO2-con)、空白组,分别制备LO2-HBx、LO2-con和LO2细胞(Mock)的条件培养基,孵育人HSC株LX-2,分为LX-2/LO2-HBx、LX-2/LO2-con、LX-2/Mock 3组,采用CCK-8法检测各组细胞增殖变化。采用rhTGFβ1刺激LX-2细胞,另采用TGFβ1受体抑制剂处理LX-2/LO2-HBx组细胞。荧光定量PCR或Western Blot法检测LO2细胞中的HBx及上述LX-2细胞中α-SMA、Col1A1、DBH和TGFβ1的表达。多组间比较采用单因素方差分析,进一步比较方法采用Bonferroni法; 2组间比较采用t检验;相关性分析采用Pearson法。结果 LO2-HBx可稳定表达HBx蛋白,其培养上清中TGFβ1含量升高(F=324.701,P 0.01);共培养LX-2/LO2-HBx组细胞发生明显细胞形态变化,出现细胞收缩,胞突明显伸长,胞内脂滴减少,与LX-2/LO2-con组比较其增殖活力明显增强(P 0.05),且α-SMA和Col1A1的mRNA(F值分别为144.712和76.680,P值均0.01)及蛋白(F值分别为234.142和528.708,P值均0.001)表达水平升高; LX-2/LO2-HBx组细胞中TGFβ1 mRNA(F=29.382,P 0.01)及DBH mRNA水平升高(F=42.662,P 0.01)。随着rhTGFβ1刺激浓度的增加,LX-2细胞中α-SMA(F=1 794.031,P 0.01)、Col1A1(F=91.340,P 0.01)及DBH(F=2 501.011,P 0.01)表达增加,在rhTGFβ1 10 ng/ml时达到峰值。在LO2-HBx组条件培养液中加入TGFβ1受体抑制剂后LX-2细胞中DBH和Col1A1的表达较对照组下调(t值分别为3.603、5.798,P值均0.05)。慢性乙型肝炎、乙型肝炎肝硬化、肝细胞癌患者的血浆TGFβ1(F=51.188,P 0.001)、HBx (F=39.227,P 0.001)、DBH(F=34.431,P 0.001)及Hyp(F=16.211,P 0.001)较健康对照组升高,血浆中HBx与TGFβ1、TGFβ1与DBH、Hyp与DBH的表达量呈正相关,r分别为0.931、0.863、0.765(P值均0.001)。结论 HBx蛋白可促进LO2细胞分泌TGFβ1,诱导LX-2的增殖和活化,促进肝纤维化的发生,并上调LX-2细胞中TGFβ1及DBH的表达;rhTGFβ1刺激可诱导LX-2活化和DBH表达上调。     

乙型肝炎患者血清HBV DNA水平与临床的分型关系

目的探讨血清HBVDNA水平与HBV血清标志物（HBVM）构成模式和临床分型的关系。方法对260例临床诊断的乙型肝炎患者，进行HBVDNA定量检测。结果HBeAg阳性患者血清HBVDNA水平最高·HBeAb阳性患者血清HBVDNA水平次之。两者比较，差异显著（P〈0．05）；急性肝炎患者血清HBVDNA水平低于慢性乙型肝炎、重型肝炎及肝炎肝硬化患者；重型肝炎患者血清HBVDNA水平低于慢性乙型肝炎、肝炎肝硬化患者。结论血清HBVDNA水平与HBV血清标志物构成模式密切相关，不同临床类型患者血清HBVDNA水平有一定的差异。     

慢性乙肝病毒感染者血清血管内皮生长因子的研究

目的:检测慢性乙型肝炎病毒感染患者血清中血管内皮生长因子(VEGF)的水平,探讨其临床意义.方法:采用双抗体夹心ELISA法对50例肝细胞癌、40例乙型肝炎肝硬化、36例乙型肝炎肝纤维化、40例慢性乙型肝炎患者血清中VEGF进行检测,并以43例健康者作为对照.同时采用全自动生化分析仪检测所有人员的肝功能常规指标.结果:慢性乙型肝炎、肝纤维化、肝硬化、肝细胞癌组患者血清VEGF浓度明显高于正常对照组(P＜0.01,P＜0.05,P＜0.05,P＜0.05),同时四组患者之间比较,差异均有统计学意义(P＜0.05).四组患者血清VEGF水平与肝功能指标AST、ALT无相关性,与GGT成正相关(r=0.337,P＜0.05).结论:VEGF与慢性乙型肝炎病毒感染者病情密切相关,可作为病情发展动态监测的指标.VEGF与GGT联合检测,可显著提高肝细胞癌的检出率.     

乙型肝炎病毒X基因转染人肝癌细胞株双向凝胶电泳图谱分析

目的 研究转染HBV X基因的人肝癌细胞株中蛋白质表达谱的改变,为筛查在HBV相关性肝细胞癌发生中发挥重要作用的关键蛋白质分子奠定基础.方法 利用分子生物学方法建立稳定表达HBV X蛋白(HBx)的肝癌细胞株HepG2+HBx,同时设空载体peDNA3转染细胞HepG2-pcDNA3及HBV全基因转染的人肝癌细胞株HepG2.2.15为对照.PCR法扩增Neo基因检测质粒DNA片段的插入,免疫印迹法检测HBx蛋白的表达.利用固相pH梯度双向凝胶电泳分离3种肝癌细胞株HepG2-pcDNA3、HepG2-HBx和HepG2.2.15的总蛋白,用图像分析软件比较、分析、识别细胞间的差异表达蛋白质.统计学分析采用t检验.结果 获得分辨率高、重复性好的3种细胞的双向电泳(2-DE)图谱.软件分析表明,HepG2-pcDNA3、HepG2-HBx和HepG2.2.15细胞的2-DE凝胶可识别蛋白点分别为(2 095±137)、(2 188±105)和(2 109±20)个.比较HepG2-pcDNA3与HepG2-HBx细胞的2-DE图谱发现37个差异显著的蛋白点,其中21个在HepG2-HBx表达上调,16个下调.6个表达量差异在5倍以上(t=0.027,P＜0.05);HepG2.2.15与HepG2-HBx细胞相比,有38个差异显著的蛋白点,其中35个在HepG2-HBx细胞中上调,3个下调,14个表达量差异在5倍以上(t=0.031,P＜0.05).结论 HBx基因转染引起人肝癌细胞株蛋白质表达谱的变化,可能与感染的肝细胞发生恶性转化的分子生物学机制有关.     

HBV相关性肝细胞癌肝组织蛋白质组差异的初步分析

目的分析HBV相关性肝细胞癌蛋白质组与癌周组织（肝硬化组织、慢性肝炎组织）蛋白质组之间的差异，鉴定其中的差异蛋白质点。方法应用双向聚丙烯酰胺凝胶电泳，对18例肝细胞癌组织与12例肝硬化组织、6例慢性肝炎组织的蛋白质组表达谱进行差异分析，应用基质辅助激光解吸离子化飞行时间质谱仪对差异蛋白质点进行了鉴定。结果肝细胞癌组织与癌周组织的对比中，共发现有表达水平存在显著差异的47个蛋白质点，17个差异蛋白质点得到了初步鉴定，其中8个蛋白质点在既往文献中未曾报道其与肝细胞癌变相关。结论慢性肝炎基础上发生的癌变与肝硬化基础上发生的癌变，其癌变机制存在差别。本实验研究中初步鉴定的差异蛋白质，可能有助于HBV相关性肝细胞癌的癌变机制、肿瘤标记和治疗靶标的进一步研究。     

GLT25D1血清水平与慢性乙型肝炎肝纤维化进程相关性分析

目的 探讨GLT25D1血清水平与慢性乙型肝炎肝纤维化进程的相关性.方法 通过抗原表位预测软件BepiPred 1.0Server将GLT25D1基因片段分为GLT25D 1-1和GLT25D 1-2两部分,PCR扩增获得目的片段,构建其原核表达质粒；对制备的多克隆抗体进行效价及特异性分析.通过以GLT25D1为抗原的ELISA双抗体夹心的方法,检测其在HBV感染不同阶段的患者的血清水平.结果 成功表达重组蛋白,Western blot鉴定正确；成功制备兔抗人(GLT25D1-1、GLT25D 1-2)的多克隆抗体,效价较高,特异性良好.通过ELISA方法检测HBV感染患者血清,慢性乙肝(病理结果不超过S3期)、肝硬化(S3-4期及S4期)以及肝癌患者中GLT25D1的OD值较正常组均有显著性差异(P＜0.01).结论 通过血清学检测结果,我们发现GTL25D1存在于HBV感染的肝病的各进程中,进而我们推测血清GLT25D1可能会作为检测肝纤维化进程的一个新的血清学指标.     

IgA-抗组织转谷氨酰胺酶抗体在慢性肝病患者中的表达

目的了解IgA-抗组织转谷氨酰胺酶（tTG）抗体在慢性肝病患者中的表达.方法以ELISA法检测26例慢性肝病患者（16例慢性肝炎,10例肝硬化）血清IgA-抗tTG抗体水平,结果＞10 AU为阳性.结果26例慢性肝病患者中有4例IgA-抗tTG抗体阳性（15.4%）,且该4例患者均为乙型肝炎肝硬化病例.Child-Pugh B级患者的抗体阳性水平略高于Child-Pugh A级.结论慢性肝病患者中存在较高的IgA-抗tTG抗体表达水平,且与门脉高压密切相关.     

Significance of anti-HBx antibodies in hepatitis B virus infection.

Serological responses to hepatitis B virus-X determinants have been noted in human sera, but conflicting findings concerning the correlation of anti-HBx antibodies with different stages of hepatitis B virus infection or pathological sequelae have been reported. Using an adenovirus-based eukaryotic vector, the 17 kD X protein was efficiently expressed in 293 cells. Cellular extracts containing the eukaryotic X protein have been used to screen for anti-HBx antibodies by immunoblot analysis in a large panel of sera from patients affected by hepatitis B virus chronic hepatitis, hepatocellular carcinoma and acute viral hepatitis. Sera from 32 of 171 (19%) chronic hepatitis B virus patients were positive for anti-HBx antibodies. Only one of thirty-two (3%) HBsAg-negative, anti-HBs/anti-HBc-positive chronic hepatitis serum was anti-HBx positive. Very few sera from primary hepatocellular carcinoma patients showed positivity for anti-HBx (8 of 149 or 5%). Anti-HBx were also detected in 8 of 48 (17%) acute viral hepatitis patients. In the four cases that were followed up weekly, anti-HBx antibodies appeared 3 to 4 wk after the onset of the clinical signs. To compare the X protein expressed in eukaryotic and prokaryotic cells as a substrate for anti-HBx antibody detection, 171 sera were screened with HBx fusion proteins expressed in Escherichia coli. The prokaryotic cell extract test seems to be more sensitive. During the chronic phase of hepatitis B virus infection, the presence of anti-HBx antibodies detected with the eukaryotic cell extract correlates with the presence of well-established markers of ongoing viral replication: serum hepatitis B virus-DNA (p less than 0.001) and intrahepatic HBcAg expression (p less than 0.001).     

肝病患者一氧化氮合酶表达异常及其临床意义

目的 探讨肝病患者抗氧化能力及一氧化氮合酶（NOS） 表达的临床价值。方法 收集26例急性肝炎（AH）、36例慢性肝炎（CH）、13例肝炎后肝硬化（LC）和23例原发性肝癌（HCC）患者的血清,分别检测其总抗氧化能力（TAO）、NOS浓度及一氧化氮（NO）水平,分析它们在肝脏疾病中的改变机制。结果 患者血清TAO在AH、CH中异常率为80％,在LC和HCC为50％;血清中NOS活性在肝病患者中的异常率在70％ 左右;NO水平在AH、CH和LC中异常率为70％,HCC组为48％。AH组、CH组TAO平均水平明显高于对照组,但LC和HCC组的差异不明显;肝病患者NO和NOS平均浓度显著高于对照组,但HCC患者NOS和NO平均浓度均低于AH、CH和LC组患者。结论 肝病患者血清NOS水平与NO浓度呈高度正相关,NO增加可能 对肝细胞起保护作用。     

Alteration of serum cytokine balances among different phases of chronic hepatitis B virus infection.

To understand the pathogenesis of chronic hepatitis B virus (HBV) infection, we examined the serum levels of IL-10, TNF-alpha IL-12 p70, and IL-12 p40 in 77 patients chronically infected with HBV and 19 controls. The patients were classified into four groups: asymptomatic carriers (ASC), patients with chronic hepatitis (CH), patients with liver cirrhosis (LC), and patients with hepatocellular carcinomas (HCC). The cytokine values among these groups were compared and their relations to clinical parameters were investigated. All these cytokine values were higher in the patient groups than in controls. IL-10 and TNF-alpha became higher in accordance with the progress of the disease phases, from ASC to LC, and lowest when the patients had HCC. IL-12 p40 was also lowest in HCC, however, the group with highest levels was CH. IL-12 p70 was unchanged among ASC, CH, and LC, but were raised in HCC. Serial analyses for the cytokine values in the same patients showed the similar tendencies. Regression analysis showed the significant correlations between ALT and IL-10. Serum cytokine values well reflected the pathological differences of the individual disease phases, and may become useful indices to understand the pathogenesis of chronic HBV infection.     

Expression of hepatocyte growth factor (HGF) and HGF receptor (c-met) proteins in liver diseases: an immunohistochemical study

BACKGROUND: Hepatocyte growth factor (HGF) is a potent mitogen for hepatocytes in vivo as well as in vitro. Serum levels of HGF vary in liver diseases, reflecting liver damage and dysfunction. However there are no studies reporting expression of HGF and HGF receptor (c-met protein) simultaneously in various liver diseases. METHODS: To clarify the clinical significance of HGF/c-met protein expression in liver diseases, liver tissues from 62 patients consisting of 7 with acute hepatitis (AH), 20 with chronic hepatitis (CH), 9 with liver cirrhosis (LC) and 26 with hepatocellular carcinoma (HCC) were immunohistochemically examined. RESULTS: Intense staining of HGF was observed in patients from AH, CH and LC, although no immunoreactivity was seen in HCC. The expression of c-met protein was higher in patients with HCC and AH than in those with CH (p < 0.05). A correlation of immunoreactivity between HGF and c-met protein was not observed expect in patients with LC (p < 0.01). The extent of c-met expression had no correlation with differentiation of HCC, tumour size, presence of portal invasion, or serum AFP levels. CONCLUSION: The results of the present study suggest that HGF plays an important role in human liver diseases, mostly in a manner independent of c-met protein expression.     

Impact of occult hepatitis B virus infection and prior hepatitis B virus infection on development of hepatocellular carcinoma in patients with liver cirrhosis due to hepatitis C virus

Objective. Although hepatitis B virus (HBV) DNA can be detected in liver or sera of patients without serum hepatitis B surface antigen (HBsAg), its clinical relevance in hepatocarcinogenesis remains controversial. This observational cohort study was conducted to clarify the risk factors, including the presence of serum HBV DNA and hepatitis B core antibody (anti-HBc), for hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-related liver cirrhosis (LC). Material and methods. The study comprised 123 patients with LC due to HCV, and negative for HBsAg. The risk factors for HCC development were analyzed by univariate and multivariate analysis. Serum samples were assayed for HBV DNA using real-time polymerase chain reaction. Results. Serum HBV DNA was detectable in 14 patients (11.4%) and serum anti-HBc in 96 (78.0%). During the follow-up period (mean 53.3 months), 80 patients (65.0%) developed HCC. The cumulative HCC development rate was significantly higher in the anti-HBc-positive group than in the anti-HBc-negative group (p=0.0039), but did not differ between the serum HBV DNA-positive and -negative groups (p=0.8570). The multivariate analysis indicated that male gender, alpha-fetoprotein (AFP) 20 ng/ml or greater, average serum alanine aminotransferase (ALAT) 80 IU/l or greater and the presence of anti-HBc were independent risk factors for development of HCC (p=0.038, p=0.013, p=0.020 and p=0.001, respectively). Conclusions. Serum anti-HBc, which indicates a previous HBV infection, has clinical significance in hepatocarcinogenesis in patients with HCV-related LC, but serum HBV DNA does not. Therefore, anti-HBc in serum is a significant predictor for HCC.     

Hepatitis B virus genotypes and clinical manifestation among hepatitis B carriers in Thailand

BACKGROUND: Hepatitis B virus (HBV) genotypes have distinct geographic distributions. The aim of the present study was to evaluate the distribution of HBV genotypes and their clinical relevance in Thailand. METHODS: Hepatitis B virus genotypes among 107 hepatitis B carriers residing in Thailand were evaluated using serologic and genetic methods. They were clinically classified into asymptomatic carriers with normal serum alanine transaminase (ALT) levels and patients with chronic liver disease, such as those with chronic hepatitis (CH), liver cirrhosis (LC) and hepatocellular carcinoma (HCC). RESULTS: Hepatitis B virus genotype distribution among the 107 patients was 25.2% for genotype B, 72.0% for genotype C and 2.8% for genotype D. The serum ALT levels, HBV-DNA and hepatitis B e antigen positivity were significantly higher in carriers infected with genotype C HBV than in those infected with genotype B (P < 0.05). The proportion of genotype B HBV was higher in asymptomatic carriers than in patients with CH and those who developed liver disease, such as LC and HCC (45.5, 16.9 and 25.0%, respectively; P < 0.05). In contrast, the proportion of genotype C HBV was higher in patients who developed liver disease and CH than in asymptomatic carriers (68.7, 83.0 and 50.0%, respectively; P < 0.05). Phylogenetic analysis based on entire genome sequences revealed three HBV isolates, which were classified into a subgroup of genotype C in isolates from South-East Asian countries. CONCLUSIONS: Genotypes B and C are the predominant types among hepatitis B carriers residing in Thailand and those genotypes influence the clinical manifestation in carriers with chronic hepatitis B infection.     

Distribution of the heterogeneity of des-gamma-carboxyprothrombin in patients with hepatocellular carcinoma

BACKGROUND AND AIM: Our aim was to evaluate the heterogeneity of des-gamma-carboxyprothrombin (DCP) in the plasma of patients with hepatocellular carcinoma (HCC), benign liver diseases, and normal controls and compare the DCP values by enzyme-linked immunosorbent assay (ELISA) for two types monoclonal antibodies (MU-3 and 19B7). METHODS: We purified DCP from the plasma of 17 patients with HCC, three patients with metastatic liver tumors (MTLT), 12 with acute hepatitis (AH), five with chronic hepatitis (CH), nine with liver cirrhosis (LC), and 10 normal controls (NC). The DCP was analyzed by using immunoaffinity chromatography, reversed-phase high-performance liquid chromatography and measured by using an ELISA. RESULTS: In HCC, the synthesis of the 1-, 3-, and 4-Gla (gamma-carboxyglutamic acid) DCP variants markedly increased, and those levels accounted for more than 50% of the DCP. The synthesis of the 3-, and 4-Gla DCP gradually increased in order of AH, CH, and LC patients. The MU-3 antibody reacted with the 1-, 3- and 4-Gla DCP variants, whereas the 19B7 antibody reacted with the 6-, 7- and 8-Gla variants. The DCP was measured by ELISA, markedly increased in order of NC, AH, CH, LC, and HCC cases. The correlation of the ratios (1 + 3 + 4)-Gla/(6 + 7 + 8)-Gla DCP and MU-3/19B7 was positive and statistically significant (r = 0.786, n = 56). CONCLUSIONS: According to the severity of liver damages, the synthesis of the 1-, 3- and 4-Gla DCP variants that lost the Ca binding from the outside of the Gla-domain of the prothrombin molecule increases and the MU-3/19B7 ratio is believed to reflect this.     

HBsAg及HBV DNA定量水平在慢性乙型肝炎、肝硬化和肝癌患者中的变化

目的 了解HBsAg定量水平在慢性乙型肝炎、乙型肝炎肝硬化、HBsAg阳性的原发性肝癌患者中的变化及其在3组患者中与HBV DNA的相关性. 方法 采集47例慢性乙型肝炎患者(乙型肝炎组),72例乙型肝炎肝硬化患者(肝硬化组)及54例肝癌患者(肝癌组)的血清标本,用雅培化学发光法进行HBsAg定量测定,荧光PCR定量法检测HBV DNA量水平.多组分析采用Kruskal-Wallis检验,两组间比较采用Mann-WhitneyU检验,相关性分析采用Spearman检验.结果 HBsAg定量值在乙型肝炎、肝硬化、肝癌组患者中的中位数分别为2361.10、1001.64、594.35IU/ml,3组间呈逐渐下降趋势,x2= 24.394,P＜0.05,差异有统计学意义;乙型肝炎组与肝硬化组比较,Z= -3.754,P＜0.05,差异有统计学意义;乙型肝炎组与肝癌组比较,Z=-4.630,P＜0.05,差异有统计学意义;而肝硬化组与肝癌组比较,差异无统计学意义.HBeAg阳性患者,HBsAg定量值在乙型肝炎组、肝硬化组、肝癌组患者的中位数分别为3259.83、1077.30、789.72 IU/ml,3组间呈下降趋势,x2= 15.643,P＜0.01,差异有统计学意义.对于HBeAg阴性患者,HBsAg定量值在乙型肝炎组、肝硬化组、肝癌组患者的中位数分别为1669.00、1001.64、582.05 IU/ml,3组间呈下降趋势,x2 =6.423,P＜0.05,差异有统计学意义.HBV DNA定量值在乙型肝炎组、肝硬化组、肝癌组患者的中位数分别为5.3579、 4.2207、1.0000 log10拷贝/ml,4分位数间距分别为(4.3579 ～6.8745)、(0.0000 ～ 5.7393)、(0.0000 ～ 4.6651)log10拷贝/ml,3组HBV DNA定量值比较,x2=31.412,P＜0.05,差异有统计学意义; HBsAg与HBV DNA在乙型肝炎组(r= 0.297,P＜0.05)、肝硬化组(r= 0.346,P＜0.05)、肝癌组(r=0.452,P＜0.05)均呈正相关.结论 HBsAg定量值在慢性乙型肝炎、肝硬化、肝癌患者中逐渐降低,且与HBV DNA水平正相关.     

Hepatitis B virus subgenotypes and basal core promoter mutations in Indonesia

AIM： To identify the distribution of hepatitis B virus （HBV） subgenotype and basal core promoter （BCP） mutations among patients with HBV-associated liver disease in Indonesia.
METHODS： Patients with chronic hepatitis （CH, n =61）, liver cirrhosis （LC, n = 62）, and hepatocellular carcinoma （HCC, n = 48） were included in this study. HBV subgenotype was identified based on S or preS gene sequence, and mutations in the HBx gene including the overlapping BCP region were examined by direct sequencing.
RESULTS： HBV genotype B （subgenotypes B2, B3, B4, 85 and B7） the major genotype in the samples, accounted for 75.4%, 71.0% and 75.0% of CH, LC and HCC patients, respectively, while the genotype C （subgenotypes C1, C2 and C3） was detected in 24.6%, 29.0%, and 25.0% of CH, LC, and HCC patients, respectively. Subgenotypes B3 （84.9%） and C1 （82.2%） were the main subgenotype in HBV genotype B and C, respectively. Serotype adw2 （84.9%） and adrq＋ （89.4%） were the most prevalent in HBV genotype B and C, respectively. Double mutation （A1762T/G1764A） in the BCP was significantly higher in LC （59.7%） and HCC （54.2%） than in CH （19.7%）, suggesting that this mutation was associated with severity of liver disease. The T1753V was also higher in LC （46.8%）, but lower in HCC （22.9%） and CH （18.0%）, suggesting that this mutation may be an indicator of cirrhosis.
CONCLUSION： HBV genotype B/B3 and C/C1 are the major genotypes in Indonesia. Mutations in BCP, such as A1762T/G1764A and T1753V, might have an association with manifestations of liver disease.     

The SHAP-hyaluronan complex in serum from patients with chronic liver diseases caused by hepatitis virus infection.

Our previous study suggested that the serum-derived hyaluronan associated protein (SHAP)-hyaluronan (HA) complex in the sera of patients with rheumatoid arthritis is useful as a marker that directly correlates with the degree of inflammation. Here, we have investigated the serum levels of the SHAP-HA complex in patients at various clinical stages of chronic hepatitis (CH), liver cirrhosis (LC), and hepatocellular carcinoma (HCC) caused by infection with the hepatitis C or hepatitis B virus. Both serum levels of the SHAP-HA complex and HA in those patients were significantly higher than those of the controls and increased in the order of CH相似文献