原发性肝细胞癌HBsAg、Fas及PCNA抗原表达及其意义.docVIP

原发性肝细胞癌HBsAg、Fas及PCNA抗原表达及其意义 　 作者：姜润德 宗宁 李占元 王占民 【摘要】目的：通过检测原发性肝细胞癌（HCC）及其癌周肝组织HBsAg、Fas抗原和增殖细胞核抗原（PCNA）的表达，探讨其表达的规律和意义以及HBV感染与HCC的相关关系，HCC发生的机制。方法：对52例肝癌标本及42例癌周肝组织应用免疫组织化学方法检测HBsAg、Fas和PCNA的表达，并结合血清甲胎蛋白（AFP）水平进行分析。结果：癌周肝组织高度表达HBsAg和Fas，阳性率均达78.6%，癌组织表达阳性率分别为21.2%和30.8%，阳性表达仅限于分化良好者，差异有统计学意义（P均＜0.005）。癌组织和癌周组织HBsAg和Fas的表达具有相关性。癌组织的PCNA标记指数（54.8±25.9），显著高于癌周组织（11.6±9.7)（P＜0.001），其中HBsAg阳性者标记指数又低于HBsAg阴性者（41.4±28.5 vs 58.4±24.2，P＜0.05)。在癌周组织PCNA阳性细胞常常位于肝小叶周边部，体积较小，核圆形或卵圆形。结论：由于高分化癌具有低水平表达HBsAg的能力，推测HBsAg在癌组织中的表达消失或低表达应归因于癌细胞的低分化状态。癌周组织持续发生肝细胞的凋亡，但在癌组织尤其是低分化癌组织中则减弱或消失，可能归因于癌细胞不能表达病毒抗原。卵圆形细胞的异常增殖可能是肝癌发生的前提条件。 【关键词】癌，肝细胞#12539;肝炎表面抗原，乙型#12539;抗原，CD95#12539;增殖细胞核抗原 Expression of HBsAg,Fas and PCNA in hepatocellular carcinoma and their significance in understanding HBV related hepatocarcinogenesis 【ABSTRACT】Objective:To investigate the expressive characters and their significance by detecting the expressions of HBsAg,Fas and proliferating cell nuclear antigen(PCNA) in both hepatocellular carcinoma(HCC) and their surrounding noncancerous tissues.The correlation between HBV infection and HCC,and the possible mechanism of hepatocellular carcinogenesis were discussed.Methods:HBsAg,Fas and PCNA were detected by immunohistochemistry from 52 cases of hepatocellular carcinoma as well as 42 corresponding noncancerous tissues.Clinical data suchas serum AFP levels was also analysed.Results:Both HBsAg and Fas were strongly expressed in noncancerous tissues,with positive rate of each achieving 78.6%.However their expression rates in cancer tissues were 21.2% and 30.8% respectively,significantly lower and less intensive than that of their corresponding noncancerous ones(P＜0.005).The expression in cancer tissues are only found in the well differentiated types.Close correlations were found for HBsAg and Fas expressions in both cancer and noncancerous tissues.The average PCNA labeling index(PCNA LI)of HCC was 54.8±25.9,significantly higher than that of noncancerous tissues,which is o