肝癌和癌旁组织中乙型肝炎表面抗原及丙型肝炎抗原表达与肝纤维化标志物的相关性

目的研究肝癌组织、癌旁组织中乙型肝炎表面抗原(HBsAg)、丙型肝炎抗原表达与血清肝纤维化标志物的相关性。方法采用免疫组织化学法对肝癌组织及癌旁组织中的HBsAg、丙型肝炎抗原表达进行了标记和分析,同时检测其血清肝纤维化标志物水平,并研究它们的相关性。结果肝癌血清肝纤维化标志物水平在乙型、丙型肝炎病毒混合感染组中最高,单独乙型、丙型肝炎病毒感染组次之,无病毒感染组最低,肝癌组织、癌旁组织中HBsAg、丙型肝炎抗原表达与透明质酸、层黏连蛋白、Ⅳ型胶原蛋白呈正相关,相关系数分别为0.60、0.45、0.46,P值均<0.01。结论肝癌遵循慢性病毒性肝炎、肝硬化、肝癌的发展趋势,有病毒感染的肝癌组织,其血清肝纤维化水平明显高于无病毒感染者。一方面病毒的感染是肝癌发生的原因,另一方面长期的病毒血症会加重肝脏组织病变,所以病毒性肝炎的抗病毒干预治疗对肝癌的预后有着积极的意义。

Correlation between HBsAg, HCV expression in cancerous and pericancer tissues of hepatocellular carcinoma and liver fibrosis markers in serum

OBJECTIVE: To study the correlation between HBsAg and HCV in hepatocellular carcinoma (HCC) pericarcinomatous tissues and serum liver fibrosis markers. METHODS: The patterns of HBsAg and HCV in 100 cases of HCC and their surrounding liver tissues were studied with paraffin sections using immunohistochemistry techniques. Hyaluronic acid (HA), procollagen III peptide (PIIIP), collagen IV (CIV), and laminin (LN) were detected by radioimmunoassay. RESULTS: The levels of HA, PIIIP, CIV and LN in the HBV and HCV coinfection group were the highest among the four groups. The levels of HA, PIIIP, CIV and LN in the groups not infected by HBV and HCV were the lowest among the four groups. HBV and HCV expressions were positively correlated with HA, LN and CIV and their Spearman's rank correlation coefficients were 0.60, 0.45, 0.46, respectively (P < 0.01). CONCLUSION: Liver cancer development follows a sequential trend of chronic hepatitis, liver cirrhosis, and liver cancer. In the tissues of liver cancer with virus infection background, the serum marker level of hepatic fibrosis is obviously higher than those without virus infection background. On the one hand, virus infection is one of the reasons causing liver cancer; and on the other hand, longstanding viremia will aggravate pathological changes of liver tissues. Therefore antivirus treatment of hepatitis is of significance for the prognosis of liver cancer.