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目的 :探讨丁型肝炎病人肝组织中HDAg与HBsAg/HBcAg和HBVDNA表达及关系。 方法 :应用免疫组化双重染色和原位杂交 ,检测 79例丁型肝炎病人肝组织HDAg、HBsAg、HBcAg和HBVDNA表达 ,以 5 2例乙型肝炎作对照。结果 :丁型肝炎HBsAg、HBcAg检出率 ( 81%、71%)较乙型肝炎 ( 94%、92 %)低 (P<0 0 5或 0 0 1)。HDAg以肝细胞核表达为主 ,HBsAg以肝细胞浆表达为主 ,HDAg和HBsAg表达强度及阳性细胞分布呈一致性 ,且与肝组织的炎症活动和病理损害程度相关 (P <0 0 1)。HBcAg以肝细胞核表达为主 ,阳性细胞主要呈单个细胞或点状分布 ,且HBcAg阳性细胞明显少于HDAg阳性细胞。HDAg表达强度与HBVDNA表达呈负相关 (P <0 0 5 )。结论 :HDV感染会抑制HBVDNA复制或病毒抗原表达 ;在HDV致病机制中既有HDV的直接细胞毒性作用 ,也有HBV和HDV的协同作用。
Objective: To investigate the expression of HDAg, HBsAg / HBcAg and HBVDNA in the liver of patients with hepatitis D and their relationship. Methods: The expression of HDAg, HBsAg, HBcAg and HBVDNA in 79 patients with hepatitis D were detected by immunohistochemical double staining and in situ hybridization. Fifty two patients with hepatitis B were used as controls. Results: The detection rates of HBsAg and HBcAg in hepatitis B were lower than those in hepatitis B (81%, 71%) (94%, 92%) (P <0.05 or 0.01). HDAg was mainly expressed in hepatocytes, and HBsAg was mainly expressed in hepatocytes. The expression intensity of HDAg and HBsAg and the distribution of positive cells were consistent with the degree of inflammatory activity and pathological damage (P <0.01). HBcAg is mainly expressed in the nucleus of hepatocytes, positive cells are mainly single or dotted distribution, and HBcAg positive cells are significantly less than HDAg positive cells. HDAg expression intensity was negatively correlated with HBVDNA expression (P <0.05). Conclusion: HDV infection can inhibit the replication of HBVDNA or the expression of viral antigens. In HDV pathogenesis, there are both the direct cytotoxicity of HDV and the synergistic effect of HBV and HDV.