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目的探讨在乙型肝炎病毒(HBV)相关肝细胞癌(HCC)患者癌组织中HBsAg和肝细胞核因子4α(HNF4α)表达及其与组织学分化的关系。方法回顾性分析2008年11月~2013年3月首都医科大学附属北京佑安医院经术后病理学检查证实为HCC组织256例。采用免疫组化法检测HBsAg、HNF4α和磷脂酰肌醇蛋白聚糖-3(GPC-3)表达。结果在256例HCC癌组织中,发现HBsAg阳性12例(4.7%);在39例高分化、119例中分化和98例低分化肿瘤组织中,HBsAg阳性率分别为20.5%、1.7%和2.0%,前组显著高于后两组(P<0.05);HNF4α阳性百分比在高分化癌患者中为65.6%(21/32),显著高于中、低分化癌患者18.8%(3/16,P<0.001);在12例HBsAg阳性癌组织中,HNF4α阳性11例(91.7%),而在选择的36例HBsAg阴性癌组织中,HNF4α阳性13例(36.1%,P<0.05);在4例HBsAg阳性中分化和低分化HCC组织中,免疫组化显示GPC-3呈补丁样分布。结论 HBsAg在HBV相关HCC患者肿瘤细胞中的低表达可能与肿瘤细胞低表达HNF4α有关。
Objective To investigate the relationship between the expression of HBsAg and the expression of nuclear factor 4α (HNF4α) in hepatocellular carcinoma (HCC) patients with hepatocellular carcinoma (HCC) and its relationship with histological differentiation. Methods Retrospective analysis from November 2008 to March 2013 Beijing You’an Hospital Affiliated to Capital Medical University postoperative pathology confirmed 256 cases of HCC. Immunohistochemistry was used to detect the expression of HBsAg, HNF4α and Glypican-3 (GPC-3). Results In 256 cases of HCC, 12 cases (4.7%) were positive for HBsAg. The positive rates of HBsAg in 39 cases of well differentiated, 119 cases of moderately differentiated and 98 cases of poorly differentiated tumors were 20.5%, 1.7% and 2.0% respectively %, The former group was significantly higher than the latter two groups (P <0.05). The positive percentage of HNF4α in patients with well-differentiated carcinoma was 65.6% (21/32), which was significantly higher than that in moderate and poorly differentiated carcinoma (18.8%, 3/16, P <0.001). HNF4α was positive in 11 cases (91.7%) in 12 cases of HBsAg positive cancerous tissues and 13 cases (36.1%, P <0.05) in 36 cases of HBsAg negative cancerous tissues. In HBsAg-positive, moderately differentiated and poorly differentiated HCC tissues, immunohistochemistry revealed a patch-like distribution of GPC-3. Conclusion The low expression of HBsAg in the tumor cells of HBV-related HCC patients may be related to the low expression of HNF4α in tumor cells.