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目的 探讨原发性肝癌中乙型肝炎病毒感染与凋亡基因bcl-2、bax、Fas及FasL表达的关系。方法 采用免疫组化技术分析40例原发肝细胞癌组织中乙肝病毒表面抗原(HBsAg) 阳性组和HBsAg阴性组bcl-2、bax、Fas及FasL的表达。结果 癌组织中HBsAg阳性率为30%(12/40)，癌旁组织中HBsAg阳性率为62.5%(25/40)。12例HBsAg阳性的癌组织中bcl-2和bax的阳性率比值为1：1.5(2/12: 3/12)，28例HBsAg阴性的癌组织中bcl-2和bax阳性率比值为1:1.25(4/28: 5/28)；25例HBsAg阳性和15例HBsAg阴性的癌旁肝细胞中bcl-2和bax的阳性率比值分别为1:3.2 (5/25：16/25) 和1:3(3/15: 9/15)。12例HBsAg阳性和28例HBsAg阴性的肝癌中Fas 和FasL阳性例数分别为6、5和1、1；25例HBsAg阳性和15例HBsAg阴性的癌旁肝细胞Fas和FasL阳性例数分别为17、5和4、3。两组间比较均有明显差异(P<0.05)。结论 肝癌组织中HBV感染与bcl-2和bax阳性表达比率无明显关系，而与Fas和FasL的表达有关。
Objective To investigate the relationship between hepatitis B virus infection and the expression of apoptosis genes bcl-2, bax, Fas and FasL in primary liver cancer. Methods Immunohistochemistry was used to analyze the expression of bcl-2, bax, Fas and FasL in HBsAg-positive group and HBsAg-negative group in 40 cases of primary hepatocellular carcinoma. Results The positive rate of HBsAg in cancer tissues was 30% (12/40), and the positive rate of HBsAg in adjacent tissues was 62.5% (25/40). The positive ratio of bcl-2 and bax in 12 cases of HBsAg-positive cancer tissues was 1:1.5 (2/12:3/12). The ratio of positive rates of bcl-2 and bax in 28 cases of HBsAg-negative cancer tissues was 1: 1.25 (4/28: 5/28); the ratio of positive rates of bcl-2 and bax in 25 cases of HBsAg positive and 15 cases of HBsAg negative hepatic cells were 1:3.2 (5/25:16/25) and 1:3 (3/15: 9/15). The positive number of Fas and FasL in 12 cases of HBsAg positive and 28 cases of HBsAg-negative liver cancer were 6, 5, and 1, respectively; the number of Fas and FasL positive cases of 25 cases of HBsAg positive and 15 cases of HBsAg negative hepatocellular carcinoma were 17, 5 and 4, 3. There were significant differences between the two groups (P<0.05). Conclusion The HBV infection in hepatocellular carcinoma is not related to the positive expression ratio of bcl-2 and bax, but is related to the expression of Fas and FasL.