肝组织内丙型肝炎病毒不同抗原的定位及比较

目的研究ＨＣＶ不同抗原的组织内定位以及与病变和血ＨＣＶＲＮＡ的关系。方法５１份慢性丙型肝炎肝穿刺组织，免疫组化检测ＨＣＶＣＰ１０、ＮＳ３和ＮＳ４，其中３２份还检测ＮＳ５，同时观察组织学病变和血ＨＣＶＲＮＡ（ＲＴＰＣＲ法）。结果ＨＣＡｇ总阳性率＞６０％。不同抗原阳性率不一，以ＣＰ１０和ＮＳ５为高（各＞５０％）。阳性细胞数一般较少，散在分布；灶性集聚时，多与碎屑坏死及炎症反应相伴。几种抗原全阳性者组织病变活动度较高。血ＨＣＶＲＮＡ阳性率８０．３９％，但血与组织检测结果的重合性仅占５０．９８％；血阴性者，８／１０份组织内检出１或多种抗原。结论组织内同时检测多种抗原能提高ＨＣＡｇ检出率。

Localization and comparison of varied HCV antigens in liver tissue

Objective To compare the localizations of varied HCAg in liver tissue and to study their relationship with histopathology and expression of HCV RNA in serum. Methods HCAg CP10, NS3 and NS4 were localized immunohistochemically in 51 liver tissues biopsied from the chronic hepatitis C cases, and NS5 was also detected in 32 of 51 specimens. Histopathologic activity and HCV RNA in serum (RT PCR) were investigated simultaneously.Results Total positive rate of HCAg was >60%. The frequencies of varied HCAg were different, the highest rate of which was CP10 and NS5 (>50%). The positive cells were usually scattered in most of the specimens. The clustered positive cells were found near the portal tract accompaning with the pieacemeal necrosis and inflammative reaction. The histopathologic activity was higher in the cases with positive results of all HCAg detected. The positive rate of serum HCV RNA was 80.39 %. However, the coincident rate of HCV detection in serum and in tissue was only 50.98%, 1 or more HCAg were found to be in 8 specimens among the 10 of negative serum HCV RNA. Conclusion Detection of more kinds of HCAg in the same specimen will raise the positive rate of infected cases.