慢性肝病及原发性肝癌患者血清中自身抗体分析

目的：探讨慢性肝炎、肝硬化和原发性肝癌患者血清中自身抗体的变化规律。方法：收集３４２例慢性肝病和肝癌血清标本，以 Ｈｅｐ－２细胞和猴肝组织为抗原基质，采用间接免疫荧光法检测自身抗体。结果：慢性肝炎、肝硬化、肝癌患者抗核抗体（ＡＮＡ）的阳性检出率分别为２１．８％（３５／１６０），２７．５％（３０／１０９）和３４．２％（２５／７３），均明显高于对照组的３％（６／２００）。３组ＡＮＡ核型种类较多，但均以颗粒型为主。以蛋白质印迹法检测抗可提取性核抗原（ＥＮＡ）抗体。发现４０例ＡＮＡ颗粒型的患者，有１２例ｎＲＮＰ／Ｓｍ和（或）ＳＳＡ阳性，３例Ｓｃｌ－７０和２例Ｊｏ－１阳性；１５例ＡＮＡ均质型有７例为抗双链ＤＮＡ抗体和１例抗组蛋白抗体。对照组中２例ＡＮＡ颗粒型分别为ｎＲＮＰ／Ｓｍ和ＳＳＡ阳性。３组病例的胞质抗体有多种，以抗线粒体抗体阳性率最高，肝硬化和肝癌组分别达１２．８％和１２．３％；慢性肝炎组为８．９％。结论：慢性肝炎、肝硬化、肝癌患者血清中不仅存在着自身抗体，而且显著高于正常人。ＡＮＡ的靶抗原中除一部分是目前已鉴定的外，大部分有待于进一步鉴定。

Analysis of serum autoantibodies in patients with chronic liver diseases and hepatocellular carcinoma

Objective: To analyze autoantibodies in patients with chronic liver diseases and hepatocellular carcinoma (HCC). Methods: Immunofluoresence and Western blot were used to detect the autoantibodies on Hep-2 cells and monkeys liver tissue substrates. Results:The frequencies of ANA were significantly higher (P<0. 001 ) in patients with HCC (25/73 = 34. 2% ),cirrhosis (30/109 = 27. 5 % ) and chronic hepatitis (35/160 =21. 8 % ) than in normal control. Although a rage of fluorescence patterns was observed, the percentage of granular fluorescence was highest in the 3 groups. The result of ENA showed there were 12 cases nRNP/Sm and SS-A, 3 cases Scl-70, 2 cases Jo-1, 7 cases ds-DNA and 1 cases Histone. Several fluorescence patterns were observed in cytoplasmic, the frequency of anti-mitochondrial antibody was highest in all anti- cytoplasmic antibodies. Conclusion:These changes in ANA has a close relationship with transformation from chronic liver disease to HCC.