慢性乙型肝炎肝组织HBsAg和HBcAg的免疫组化检测及其意义

应用PAP和ABC法分别对54例慢性乙肝肝组织中HBaAg和HBcAg进行检测,分析了两种抗原在肝组织中的存在状态与肝脏病理变化及血清HBV复制指标间的关系。发现肝组织中HBV抗原检出率与肝炎病变程度呈负相关(P<0.05)。三种病理类型肝组织中,HBsAg均以胞浆型为主;膜型HBsAg主要见于CAH.ASH和CPH时,HBcAg以核型表达为主,面CAH时以浆膜型为主。膜型HBsAg和浆膜型HBcAg表达区易见到肝细胞坏死及炎性细胞浸润。还发现肝组织中HBcAg的检出与血清HBcAg和HBV-DNA密切相关(P<0.005)。上述结果提示:①肝细胞损伤可能并非HBV直接作用,而是机体针对HBV的免疫反应所致;膜型HBsAg和浆膜型HBcAg可能是肝细胞免疫损伤的靶抗原。②肝组织内HBcAg的存在是HBV复制标志。

Immunohistochemical detection of HBsAg and HBcAg in chronic hepatitis B liver tissues and its significance.

HBsAg and HBcAg were detected in 54 chronic HBV infected liver tissues with PAP and ABC techniques respectively. The detective rate's of intrahepatic HBsAg and HBcAg showed an inverse relation to the extent of liver inflammatory activity(P<0. 05). In all the pathologic types of livers, HBsAg was distributed prominently in the cytoplasm, but membranous HBsAg was mainly found in CAH. In ASH and CPH liver tissues, HBcAg was mainly expressed in the nuclei, whereas cytoplasmic/membranous HBcAg was prominent in CAH. Furthermore,hepa-tocyte necroses were easily observed in the areas of both membranous HBsAg and cytoplasmic/membranous HBcAg expression. We also found that intrahepatic HBcAg expression beared a closely correlation with serum HBeAg and HBV-DNA(P<0. 005). These data suggest that( I )liver cell injury in chronic hepatitis B is probably caused not by HBV itself but by the host immune response to HBV ; membranous HBsAg and cytoplasmic/membranous HBcAg may be the target antigens involved in immune hep-atocytolysis, (2)the presence of intrahepatic HBcAg is a marker of HBV replication.