【摘要】 目的对比观察HBxAg、凋亡相关蛋白Bax和Bcl-2在乙肝相关性肝病患者肝组织中的表达,探讨HBxAg在相关肝病进展中的作用。方法收集38例慢性HBV感染(CHB)、20例乙肝肝硬化(LC)和20例HBV相关性肝细胞癌(HCC)患者的肝组织标本,采用免疫组织化学染色法检测HBxAg、Bax和Bcl-2的表达。结果 3组患者肝组织中HBxAg阳性率分别为71.1%、60.0%、65.0%,差异无统计学意义(χ2=0.754,P>0.05)。3组患者Bax蛋白阳性率差异有统计学意义(χ2=14.190,P<0.01),其中HCC、CHB组Bax阳性率均高于LC组(χ2=10.417,12.214,P均<0.01)。LC组患者肝细胞Bcl-2阳性率高于CHB组(χ2=5.968,P<0.05),HCC组患者肝组织单核淋巴细胞Bcl-2阳性率高于CHB和LC组(χ2=14.872,10.000,P均<0.01)。HBxAg表达强度与Bax及Bcl-2均无相关性(r分别为0.100和0.197,P均>0.05);高、中病毒载量组HBxAg阳性率均高于低病毒载量组(χ2分别为16.800和6.930,P均<0.05)。结论 HBxAg不直接调节Bax及Bcl-2的表达,可能通过影响其作用途径来调节细胞凋亡。CHB患者肝细胞Bax表达占优势,以凋亡为主;LC患者Bcl-2表达占优势,以抑制凋亡为主。肝组织单核淋巴细胞中Bcl-2高表达可能与疾病进展有关。高病毒载量通过HBxAg的大量表达促进肝癌的发生。更多还原

【Abstract】 Objectives To compare the expression of HBxAg and the apoptosis-related proteins Bax and Bcl-2 in liver tissue from patients with hepatitis B virus(HBV)-related liver disease and to explore the function of HBxAg in the progression of disease.Methods Liver tissue samples were collected from 38 patients with chronic HBV infection(CHB),20 with HBV-related liver cirrhosis(LC) and 20 with hepatocellular carcinoma(HCC).Immunohistochemical staining was used to detect the expression of HBxAg,Bax and Bcl-2 in liver tissue from the three groups.The chi-square test was used for group comparison and Spearman rank correlation analysis was used for correlation analysis.Results Liver tissue of the three groups was positive for HBxAg at a rate of 71.1%,60.0%,and 65.0%,respectively,and the differences in positivity were not statistically significant(χ2=0.754,P>0.05).The 3 groups had statistically significant differences(χ2=14.190,P<0.01) in positivity for Bax.Among them,patients with HCC and patients with CHB had greater positivity for Bax than did patients with LC(χ2=10.417,12.214,P<0.01).Patients with LC tested positive for Bcl-2 at a higher rate than CHB patients(χ2=5.968,P<0.05).Compared to patients with CHB and LC,patients with HCC tested positive for Bcl-2 in mononuclear lymphocytes at a higher rate(χ2 of 14.872 and 10.000,respectively,P<0.01).The intensity of HBxAg expression had no correlation with Bax and Bcl-2(r=0.100,0.197,P>0.05).Patients with high or medium viral loads tested positive for HBxAg at a higher rate than patients with a low viral load(χ2=16.800,6.930,P<0.05).Conclusion HBxAg does not directly modulate Bax and Bcl-2 expression and may regulate cell apoptosis by affecting their routes of action.Bax predominated in liver cells from patients with CHB and thus primarily led to apoptosis while Bcl-2 predominated in patients with LC and inhibited apoptosis.A high level of Bcl-2 expression in mononuclear lymphocytes may be related to disease progression.A high viral load promoted the development of liver cancer through a great quantity of HBxAg expression.更多还原