肝细胞不典型增生与肝硬化和HBV的关系

用组织学和免疫组化方法探讨116例肝组织中的肝细胞不典型增生(LCD)发生率和乙型肝炎病毒(HBV)抗原的表达情况.发现肝细胞癌(HCC)伴肝硬化的LCD发生率为21/30(70%),单纯肝硬化为2/10(20%),HCC不伴肝硬化1/12(8.33%),正常对照1/64(1.56%).试验组52例中有46例HBsAg阳性,其中24例有LCD(52.17%),而6例HBsAg阴性肝组织中无1例有LCD(P<0.05).52例中22例HBcAg阳性,其中14例有LCD(63.64%);30例HBcAg阴性,10例有LCD(33.33%),前者LCD发生率明显高于后者(P<0.05).结果还发现,HBsAg和HBcAg阳性肝硬化的LCD发生率(65.71%,77.78%)明显高于HBsAg和HBcAg阴性的肝硬化及HBsAg、HBcAg阳性的非肝硬化病例(P<0.01,P<0.05).表明LCD的发生与肝硬化和HBV都有关.

LIVER CELL DYSPLASIA IN ASSOCIATION WITH CIRRHOSIS AND HEPATITIS B VIRUS

The incidence of liver cell dysplasia(LCD)and its relationship to hepatitis B antigens (HBsAg) were studied in 116 autopsy and biopsy cases of normal, cirrhotic and cancerous livers by histologic and immunohistologic methods.LCD was found in only one of 64 (1.56%) cases with normal livers,in one of 12 (8.33%) cases with hepatocellular carcinoma (HCC) without cirrhosis, in two of 10 (20%) cases with cirrhosis only, and 21 of 30 (70%)cases with cirrhosis and HCC.Hepatitis B surface antigen (HBsAg) was found in 46 of 52 cases of cirrhotic and(or) cancerous liver tissues,24 of which (52.17%) were associated with LCD, while none was found in 6 cases of HBsAg negative liver tissues (P<0.05).HBsAg was found in dysplasia cells in nine cases.Hepatitis B core antigen (HBcAg) was found in 22/52 cases, 14/22 (63.64%) were associated with LCD, while only 10/30 cases(33.33%) of HBcAg negative liver tissues were associated with LCD.LCD in the former was significantly higher than the later (P<0.05).The incidence of LCD in HBsAg and HBcAg positive cirrhosis was significantly higher than HBsAg and HBcAg negative cirrhotic or HBsAg and HBcAg positive noncirrhotic liver tissues.These findings suggest that LCD is closely associated with HBV and cirrhosis.