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目的探讨丁型肝炎患者肝组织中HDAg与HBsAg,HBcAg和HBV DNA表达及相关性。方法应用免疫组化双重染色及连续切片技术和原位杂交,检测了79例丁型肝炎患者肝组织佃ADAg,HBsAg,HBcAg和HBV DNA表达,以52例乙型肝炎作对照。结果丁型肝炎HBsAg,HBcAg检出率为81％,71％,乙型肝炎为94％,92％,两组比较有显著性差异(P<0.05或0.01)。HDAg以肝细胞核表达为主,其次是胞质表达,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,两种抗原的表达程度与肝组织的炎症活动和病理损害相关(P<0.01)。HBcAg以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HBV DNA表达呈负相关(P<0.05)。结论 HDV感染会抑制HBV DNA复制或病毒抗原表达;在HDV致病机制中HDV的直接细胞毒性可能起主要作用,也有HBV的协同作用。
Objective To investigate the expression of HDAg, HBsAg, HBcAg and HBV DNA in patients with hepatitis D and their correlation. Methods The expression of ADAg, HBsAg, HBcAg and HBV DNA in 79 patients with hepatitis D were detected by immunohistochemical double staining and serial sections technique and in situ hybridization. 52 cases of hepatitis B were used as controls. Results The positive rates of HBsAg and HBcAg in hepatitis B were 81% and 71%, respectively. The positive rate of hepatitis B was 94% and 92% respectively. There was significant difference between the two groups (P <0.05 or 0.01). HDAg is mainly expressed in the nucleus of hepatocytes, followed by cytoplasm, HBsAg is mainly expressed in the cytoplasm of the liver, and the expression intensity of HDAg and HBsAg and the distribution of positive cells are consistent. The expression of two antigens is related to the inflammatory activity and pathology Damage related (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. The expression of HDAg was negatively correlated with HBV DNA expression (P <0.05). Conclusion HDV infection can inhibit the replication of HBV DNA or the expression of viral antigens. The direct cytotoxicity of HDV may play a major role in the pathogenesis of HDV and the synergistic effect of HBV.