凋亡诱导因子AIF在肝癌组织中的表达及临床意义

目的：探讨凋亡诱导因子（AIF）在肝细胞癌组织中的表达及其临床意义。方法：采用免疫组织化学Envision法检测75例肝细胞癌组织及其相应癌旁肝组织、30例正常肝组织中AIF的表达,并分析其表达与肝细胞癌临床病理因素的相关性。结果：肝癌组织中AIF阳性表达率明显高于癌旁组织及正常肝组织,差异均具有统计学意义（P〈0.01）。AIF在肝癌组织中的表达仅与病理分级密切相关（P〈0.01）,而与年龄、性别、肿瘤大小、临床分期、肿瘤数目、有无肿瘤包膜和有无淋巴结转移、有无门静脉癌栓均无关。结论：AIF表达可能参与了肝癌的发生和发展过程。     

肝细胞肝癌E-Cadherin蛋白的表达及其对判断肝癌肝移植疗效的意义

目的：探讨E-Cadherin蛋白在肝细胞肝癌组织中的表达及其对判断肝癌肝移植患者预后的价值。方法：选择肝细胞肝癌行全肝移植患者68例,应用免疫组化方法检测其切除的肝癌组织和癌旁正常肝组织中E-Cadherin蛋白的表达情况,并对患者进行移植术后随访,分析E-Cadherin蛋白表达与肝癌肝移植患者预后的关系。结果：肝癌组织中E-Cadherin蛋白阳性表达率明显低于癌旁组织（P〈0.01）。经Logrank检验分析显示,E-Cadherin蛋白低表达组移植后的无瘤生存率明显低于E-Cadherin蛋白高表达组（P〈0.01）。多因素Cox回归分析显示,E-Cadherin蛋白表达是影响肝细胞肝癌患者肝移植术后肝癌复发的独立预后因素之一。结论：E-Cadherin蛋白表达是一个预测肝细胞肝癌患者肝移植预后的重要因子。     

β2-微球蛋白mRNA低表达在肝细胞癌免疫逃逸中的作用

目的：研究肝细胞癌（HCC）组织中人白细胞抗原（HIA）I类分子轻链β2-微球蛋白（β2-m）在肿瘤免疫逃逸中的作用,探讨肝硬化背景对肝癌组织内β2-m的mRNA水平的影响。方法：RT—PCR法检测40例肝癌和癌旁组织中β2-m的mRNA水平,并从不同角度进行分析。结果：肝癌组织中β2-m基因mRNA水平显著低于非癌组织,肝硬变背景下肝癌组织内β2-m的mRNA水平低于无肝硬化背景的肝癌组织。结论：肝癌组织中β2-m基因mRNA水平下调,可致肝癌细胞表面HIA—I类分子低表达,这一变化与肿瘤细胞的免疫逃逸相关;HCC病人的肝硬变背景在这一机制中可能起到了某种程度的促进作用。     

人体肝癌及其相关慢性肝病的肝细胞DNA含量定量分析

利用图像分析技术对轻度慢性活动性肝炎（ＭＣＡＨ）、重度慢性活动性肝炎（ＳＣＡＨ）、小结节肝硬变（ＭＩＮＣ）、大结节肝硬变（ＭＡＮＣ）、癌周肝硬变（ＰＣ）和肝细胞癌（ＨＣＣ）及正常对照共６７例样本的肝细胞或癌细胞ＤＮＡ含量进行测定分析。结果（１）ＭＣＡＨ、ＳＣＡＨ和ＭＡＮＣ多倍体化受抑制,显示细胞分化能力下降,可能与肝癌的发生相关;（２）ＨＣＣ均为异倍体肿瘤,细胞具有较高的增殖能力并处于较低的分化状态;（３）ＰＣ倍体分布和双核细胞率介于其他非癌病变和ＨＣＣ之间,细胞分化受抑制且有向异倍体发展趋势,具有癌前病变性质;（４）ＭＩＮＣ明显多倍体化,为分化性的再生修复病变而与肝癌发生无关。因此肝细胞ＤＮＡ含量的定量分析对于了解肝细胞的增生状态,以及患者的预后评估有重要意义。     

蛋白激酶底物p36在肝硬变、肝细胞肝癌中的表达及与HBV、HCV感染的关系

本文应用鼠抗蛋白激酶底物ｐ３６单克隆抗体,采用免疫组织化学法对ｐ３６在５４例肝硬变,７９例肝细胞肝癌中的表达分布进行了研究,同时结合ＨＢＶ、ＨＣＶ感染情况分析其相互关系,结果显示：ｐ３６在肝硬变及肝细胞肝癌中定位于肝细胞或癌细胞胞浆内,在胞浆内弥漫分布,阳性细胞呈灶状或弥漫分布,部分病例癌周肝细胞信号较癌组织为强,ｐ３６在肝硬变、肝细胞癌中的阳性率分别为８８．８％（４８／５４）及８２．３（６５／７９）,ＨＢｘＡｇ在两种组织的阳性率分别为７０．４％及７６％,ＨＣＶ核心抗原在两种组织的阳性率分别为８０％及７８．５％;三者同时阳性分别为５５．５％及５８．２％;ｐ３６、ＨＢｘＡｇ同时阳性分别为６８．５％及６４．５％;ｐ３６、核心抗原同时阳性分别为７４．１％及７０．８％,我们的结果提示,肝硬变、肝细胞肝癌组织中ｐ３６存在高表达,其高表达可能与ＨＢＶ、ＨＣＶ感染密切相关     

原发性肝细胞癌组织中Beclin 1的表达及其意义

目的：探讨原发性肝细胞癌（HCC）组织中Beclin 1的表达及其在肝细胞癌发生发展中的作用。方法：应用免疫组化EnVision法检测54例肝细胞癌组织及其癌旁组织中Beclin 1的表达,分析其与肝细胞癌的病理分级、临床分期、侵袭及转移等临床病理因素的关系。结果：HCC组织中Beclin 1阳性表达率明显低于癌旁组织（X2=7.53,P〈0.01）。病理分级Ⅲ～Ⅳ、TNM分期Ⅲ～Ⅳ、存在静脉浸润和淋巴结转移的肝癌组织中的Beclin 1表达水平明显低于病理分级Ⅰ～Ⅱ、TNM分期Ⅰ～Ⅱ、无静脉浸润和淋巴结转移的肝癌组织（P〈0.01）。结论：HCC组织中存在Beclin 1表达缺失,可能与HCC的发生有着密切的关系,且对HCC的恶性生物学行为有重要影响。     

GS、E—cadherin和β-catenin在肝细胞癌中的表达及其临床意义

目的探讨谷氨酰胺合成酶（glutamine synthetaseGS）、E-钙粘蛋白（E—cadherin）和β-连环蛋白（β-catenin）在肝细胞癌中的表达及其与临床病理特征和预后的关系。方法采用免疫组织化学Envision法检测182例肝细胞癌和92例癌旁肝组织中GS、E-cadherin和β-catenin的表达情况,并分析其与临床病理特征和预后的关系。结果GS在肝细胞癌阳性表达率为77．5％,明显高于癌旁肝组织（4．3％）,差异显著（P〈0．05）;肝细胞癌E—cadherin和β-catenin异常表达率分别为59．3％和58．8％,亦高于癌旁肝组织（30．4％和26．1％）,差异显著（P〈0．05）。肝细胞癌中GS的表达与TNM分期、转移和术后复发显著相关（P〈0．05）;E—cadherin和β-catenin异常表达与脉管内瘤栓、TNM分期、转移和术后复发显著相关（P〈0．05）。肝细胞癌中GS表达与E-cadherin、β-catenin异常表达正相关。结论肝细胞癌中GS的高表达,与E-cadherin和β-catenin表达的下调,可能是肝细胞癌侵袭和转移的重要机制之一,联合检测GS、E-cadherin和β-catenin可能有助于判断肝细胞癌的恶性程度、转移潜能及预后分析。     

乙型肝炎、肝硬变和肝癌中HBxAg的表达及其在肝癌发生中的作用

对３７９例良、恶性肝组织进行的免疫组织化学研究显示,３３％的慢性迁延性肝炎（６／１８）、７６％的慢性活动性肝炎（２６／３４）、９２％的肝硬变（５７／６２）和９７％的肝细胞性肝癌（ＨＣＣ）（５８／６０）中有ＨＢｘＡｇ表达,阳性率高于ＨＢｓＡｇ或ＨＢｃＡｇ。癌周肝中的ＨＢｘＡｇ阳性率显著高于非癌周肝。与其它２种ＨＢＶ抗原不同,ＨＢｘＡｇ表达在细胞类型上有较明显的选择性,在肝小多角细胞（ＳＰＬＣ）、小细胞性不典型增生（ＳＣＤ）及ＨＣＣ中较强。与ＩＧＦⅡ、ｃ－ｅｒｂＢ－２、ｃ－ｍｙｃ和ＥＧＦ－Ｒ表达进行的对照研究表明ＨＢｘＡｇ与ＩＧＦⅡ和ｃ－ｅｒｂＢ－２这２种ＨＣＣ发生相关基因的表达关系密切。ＰＣＮＡ染色结果显示ＨＢｘＡｇ阳性组织的细胞增殖活性显著高于ＨＢｘＡｇ阴性组织。我们的结果还表明ＨＢｘＡｇ表达与肝细胞不典型增生的发生和进展有关、提出ＨＢＶＸ基因可能通过其表达产物（ＨＢｘＡｇ）首先激活ＩＧＦⅡ、ｃ－ｅｒｂＢ－２基因,继而引起显著的ＳＰＬＣ增生和ＳＣＤ而参与ＨＣＣ发生的．     

大鼠肝癌发生过程中p53的突变和甲胎蛋白的表达

采用免疫组织化学ＡＢＣ和ＰＡＰ法,对二乙基亚硝胺（ＤＥＮ）诱发大鼠肝癌发生过程中突变型ｐ５３蛋白（ｍｐ５３）和甲胎蛋白（ＡＦＰ）在肝细胞中的表达进行了系统观察。结果显示：（１）ＤＥＮ诱发大鼠肝癌发生率为１００％;（２）正常大鼠及诱癌第４周大鼠的肝细胞均不表达ｍｐ５３,至诱癌第８周,可见少量肝细胞表达ｍｐ５３,诱癌晚期的癌结节内大部分肝癌细胞呈ｍｐ５３阳性表达,ｍｐ５３免疫反应阳性产物为胞核内棕褐色颗粒;（３）正常大鼠肝细胞不表达ＡＦＰ,诱癌早期（４～８周）的大鼠肝小叶内可见少量ＡＦＰ阳性肝细胞,多为小肝细胞,呈散在分布,此后ＡＦＰ阳性肝细胞逐渐增多,晚期的癌结节内大部分癌细胞呈ＡＦＰ阳性,ＡＦＰ免疫反应阳性产物为胞浆内棕褐色颗粒。结果提示,ｍｐ５３和ＡＦＰ可作为分析肝癌进展的病理学指标     

RICH2在肝细胞肝癌中蛋白表达的研究

目的:分析肝细胞肝癌与正常肝组织中RICH2蛋白表达之间的关系,探讨RICH2在肝细胞肝癌发生发展中的作用机理。方法:选取19例肝细胞肝癌患者作为研究对象,用免疫组织化学方法检测肝癌组织和癌旁正常组织中RICH2的表达情况并采用Friedrich免疫反应评分法作为判定标准。采用非参数Wilcoxon秩和检验对RICH2在肝细胞肝癌和正常组织中的评分结果进行统计学分析。结果:19例HCC病例癌旁正常组织中RICH2表达阳性率为100%(19/19),其中RICH2表达强阳性(+++)5例(26.3%),RICH2表达弱阳性(+)和中阳性(++)分别为3例(15.8%)和11例(57.9%);而HCC组织除了两例肝硬化组织未取到癌组织外,17例病例中RICH2表达阳性率仅为11.8%(2/17),表达为+和++各占50%。肝癌组织中RICH2的表达水平显著低于癌旁组织。结论:RICH2有可能通过某种或者其中几种因素作用失活,作用于信号通路,进而促进肝细胞肝癌的发生发展。研究其作用机理,可为临床诊断、治疗及预后评估提供理论依据。     

Serum and urine metabolite profiling reveals potential biomarkers of human hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a common malignancy in the world with high morbidity and mortality rate. Identification of novel biomarkers in HCC remains impeded primarily because of the heterogeneity of the disease in clinical presentations as well as the pathophysiological variations derived from underlying conditions such as cirrhosis and steatohepatitis. The aim of this study is to search for potential metabolite biomarkers of human HCC using serum and urine metabolomics approach. Sera and urine samples were collected from patients with HCC (n = 82), benign liver tumor patients (n = 24), and healthy controls (n = 71). Metabolite profiling was performed by gas chromatography time-of-flight mass spectrometry and ultra performance liquid chromatography-quadrupole time of flight mass spectrometry in conjunction with univariate and multivariate statistical analyses. Forty three serum metabolites and 31 urinary metabolites were identified in HCC patients involving several key metabolic pathways such as bile acids, free fatty acids, glycolysis, urea cycle, and methionine metabolism. Differentially expressed metabolites in HCC subjects, such as bile acids, histidine, and inosine are of great statistical significance and high fold changes, which warrant further validation as potential biomarkers for HCC. However, alterations of several bile acids seem to be affected by the condition of liver cirrhosis and hepatitis. Quantitative measurement and comparison of seven bile acids among benign liver tumor patients with liver cirrhosis and hepatitis, HCC patients with liver cirrhosis and hepatitis, HCC patients without liver cirrhosis and hepatitis, and healthy controls revealed that the abnormal levels of glycochenodeoxycholic acid, glycocholic acid, taurocholic acid, and chenodeoxycholic acid are associated with liver cirrhosis and hepatitis. HCC patients with alpha fetoprotein values lower than 20 ng/ml was successfully differentiated from healthy controls with an accuracy of 100% using a panel of metabolite markers. Our work shows that metabolomic profiling approach is a promising screening tool for the diagnosis and stratification of HCC patients.     

不同肝病变组织中CD34、CD31、Ki-67的表达及意义

目的比较正常肝组织、慢性肝炎、肝硬化、肝细胞肝癌组织及肝转移腺癌中CD34、CD31、Ki-67不同表达,寻找有助于鉴别不同性质病变的生物学标记物.方法正常肝及病变肝组织标本共104例;其中,正常肝组织10例;慢生C型肝炎组织73例;肝硬化组织7例;肝细胞肝癌7例;结肠癌肝转移5例;乳腺癌肝转移2例.73例慢性C型肝炎组织全部为肝穿活检标本,其余组织均为手术切除标本.所有病例标本分别行CD34、CD31、Ki-67免疫组织化学染色,半定量评分系统评价染色结果.统计学分析结果数据.结果在非肿瘤组织,抗CD34阳性染色主要存在于汇管区,亦可见于汇管区周围的肝实质内血窦.阳性染色内皮细胞呈点状、线状、半环状及环状,散在或簇状分布.肿瘤组织内抗CD34阳性染色特征与非肿瘤组织相似,阳性染色血管在肿瘤组织内散布分布.CD34指数在各病变组中的表达排列顺序依次为:肝细胞肝癌>乳腺癌肝转移>结肠癌肝转移>肝硬化>慢性C型肝炎>正常肝组织,从正常肝组织至慢性肝炎至肝细胞肝癌,CD34表达明显增强.组织中,抗CD31阳性染色分布、定位、形态特征与CD34相似.CD31在慢性肝炎、肝硬化、肝细胞肝癌、结肠癌肝转移及乳腺癌肝转移组织中阳性表达率分别为:6.8%(5/73)、100%(7/7)、100%(7/7)、100%(5/5)、100%(2/2);肝癌组织中CD31染色强度明显大于非癌组织中,组间比较具有显著差异(P<0.05).Ki-67阳性染色细胞呈棕黄色核着色,散在分布于肝实质内.阳性染色细胞无形态特殊性,亦无分布上的特殊性.Ki-67在各病变组间的阳性表达率分别为:64.4%(47/73)、28.6%(2/7)、100%(7/7)、100%(5/5)、100%(2/2),其中以在结肠癌肝转移组织中表达最明显;组间比较具有非常显著差异(P<0.05).在正常肝脏、慢性C型肝炎、肝硬化、肝细胞肝癌CD34、CD31、Ki-67三种生物学标记物在同一标本同时表达的阳性率分别为:0%(0/0)、4.1%(3/73)、28.6%(2/7)、100%(7/7),CD34、CD31、Ki-67其中任两种同时表达的阳性率分别为0%(0/10)、63.0%(46/73)、100%(7/7)、100%(7/7).结论 CD34是慢性肝病、肝癌临床病理评价的指标之一,CD34与CD31、Ki-67同时分析有助于建立可靠的诊断.     

Alteration of liver glycopatterns during cirrhosis and tumor progression induced by HBV

The incidence of hepatocellular carcinoma (HCC) is closely correlated with hepatitis B virus (HBV)-induced liver cirrhosis. Structural changes in the glycans of serum and tissue proteins are reliable indicators of liver damage. However, little is known about the alteration of liver glycopatterns during cirrhosis and tumor progression induced by HBV infection. This study compared the differential expression of liver glycopatterns in 7 sets of normal pericarcinomatous tissues (PCTs), cirrhotic, and tumor tissues from patients with liver cirrhosis and HCC induced by HBV using lectin microarrays. Fluorescence-based lectin histochemistry and lectin blotting were further utilized to validate and assess the expression and distribution of certain glycans in 9 sets of corresponding liver tissue sections. Eight lectins (e.g., Jacalin and AAL) revealed significant difference in cirrhotic tissues versus PCTs. Eleven lectins (e.g., EEL and SJA) showed significant alteration during cirrhotic and tumor progression. The expression of Galα1-3(Fucα1-2)Gal (EEL) and fucosyltransferase 1 was mainly increasing in the cytoplasm of hepatocytes during PCTs-cirrhotic-tumor tissues progression, while the expression of T antigen (ACA and PNA) was decreased sharply in cytoplasm of tumor hepatocytes. Understanding the precision alteration of liver glycopatterns related to the development of hepatitis, cirrhosis, and tumor induced by HBV infection may help elucidate the molecular mechanisms underlying the progression of chronic liver diseases and develop new antineoplastic therapeutic strategies.     

Specific gene expression patterns in liver cirrhosis

Liver cirrhosis (LC) is a complex disease that can develop into hepatocellular carcinoma (HCC). In an effort to investigate genetic differences between LC and HCC, we used cDNA microarray analysis to characterize the gene expression profiles in LC and HCC tissues. Consistent differences were observed among the expression patterns in LC, HCC, and normal liver tissues. Interestingly, the expression patterns of LC without tumor association (LCT) were also readily distinguished from those of LC tissues near hepatic tumor tissues (near-tumor tissue, NTT). Moreover, 25 cirrhosis-specific genes could be used to divide the NTT samples into two groups: inflammatory active cirrhosis (NTTa) and inflammatory inactive cirrhosis (NTTi). We found that NTTa samples showed gene expression patterns similar to those of the LCT and HCC groups, whereas the expression patterns of the NTTi group were significantly different from those of the LCT, NTTa, and HCC groups. Finally, we selected two of the 25 LC-specific genes and showed that these markers could be used to successfully discriminate among the different LC subtypes. Collectively, these novel results allow the identification of new genetic subgroups of LC and provide new candidate genes for use as early markers for active cirrhosis and HCC.     

Immunohistochemical expression of pi class glutathione S-transferase and alpha-fetoprotein in hepatocellular carcinoma and chronic liver disease

OBJECTIVE: To determine whether tumor marker pi glutathione transferase (GST-pi) is expressed in hepatocellular carcinoma (HCC) and other chronic liver diseases and to compare its expression with that of alpha-fetoprotein (AFP). STUDY DESIGN: Samples used were formalin-fixed, paraffin-embedded liver tissues: normal (n = 3), chronic hepatitis B (n = 15), cirrhosis (n = 15) and HCC (n = 30). The expression of AFP and GST-pi was detected by using immunohistochemistry with the peroxidase-antiperoxidase method. AFP immunoreactivity was based on the cytoplasm of the hepatocytes, while GST-pi immunoreactivity was based on the nuclei of hepatocytes. RESULTS: In normal liver tissues, AFP was not expressed. However, there was strong staining of GST-pi in bile duct epithelium cells and weak staining in hepatocytes. Our results showed higher AFP immunoreactivity in cases of HCC (36.7%) as compared to cirrhosis (6.7%) and hepatitis B (0%), whereas GST-pi immunoreactivity was lower in cases of HCC (53.3%) as compared to cases of cirrhosis (100.0%) and hepatitis B (93.3%). Percent sensitivity of AFP determination for HCC was 36.7% as compared to 53.3% for GST-pi, thus making GST-pi a more sensitive marker for detection of HCC. This study showed a significant relationship between the intensity and percentage of cells stained in hepatitis B, cirrhosis and HCC for GST-pi immunoreactivity (P < .001, .001 and .05, respectively) but not for AFP (P > .05). Statistical analysis showed that there was no significant relationship between expression of AFP and GST-pi in cirrhosis and HCC cases. Hepatitis B virus infection in HCC cases showed a positive rate of 46.7%, with AFP staining positively in 42.9% of tissues and GST-pi staining positively in 57.1% of tissues. CONCLUSION: AFP is a diagnostic but rather insensitive tissue marker for HCC. However, the absence of AFP in benign chronic liver disease makes this marker useful in differentiating between HCC and other chronic liver diseases, whereas GST-pi can be used as a diagnostic marker for HCC as well as in detecting other chronic liver diseases.     

脾切除术对肝癌发生的影响

目的:探讨脾切除术对肝炎后肝硬化脾亢患者的肝癌发生发展的影响。方法:回顾性研究369名肝硬化脾亢伴或不伴肝癌患者,经倾向性得分匹配方法(PS法)均衡分为无脾切除组(246例)和脾切除组(123例),分别比较脾切组中脾切除术对患者肝功能的影响和两组间肝癌发生率的差异。结果:脾切除术后患者AST、ALT在短期内有轻微升高,WBC和PLT记数明显增加,血清TBIL和PT也都降低。无脾切除组和脾切除组的肝癌发生率分别为33.33%和12.26%,卡方检验结果P<0.05,有统计学意义。结论:脾切除术不但可以改善肝硬化肝癌患者的肝功能,还可以降低肝硬化脾亢患者肝癌发生的危险。     

Human plasma carboxylesterase 1, a novel serologic biomarker candidate for hepatocellular carcinoma

To identify and characterize a serologic glycoprotein biomarker for hepatocellular carcinoma (HCC), multi‐lectin affinity chromatography was used to isolate intracellular N‐linked glycoprotein fractions from five paired non‐tumor and tumor tissues. From the series of 2‐D DIGE targeted differentially expressed N‐linked glycoproteins, we identified human liver carboxylesterase 1 (hCE1), which was remarkably down‐regulated in tumor tissues, a finding confirmed by Western blot, a quantitative real‐time RT‐PCR, and immunohistochemical staining of non‐tumor and tumor tissues from total 58 HCC patients. To investigate whether hCE1 is also present in human plasma, we employed a magnetic bead‐based immunoprecipitation followed by nano‐LC‐MS/MS analysis, and we found for the first time that hCE1 is present in human plasma as opposed to that in liver tissues. That is, from normalization of hCE1 signal by the immunoprecipitation and Western blot analysis, hCE1 levels were increased in plasma specimens from HCC patients than in plasma from other disease patient groups (e.g. liver cirrhosis, chronic hepatitis, cholangiocarcinoma, stomach cancer, and pancreatic cancer). From the receiver operating characteristic analysis in HCC, both sensitivity and specificity were shown to be greater than 70.0 and 85.0%, respectively. Thus, the high‐resolution proteomic approach demonstrates that hCE1 is a good candidate for further validation as a serologic glycoprotein biomarker for HCC.     

HBV基因型、基本核心启动子区双突变和肝细胞癌发生及临床病理特征的关系

目的探讨乙型肝炎病毒(HBV)基因型、基本核心启动子(BCP)区双突变(简称BCP双突变)和肝硬化(LC)、肝细胞癌(HCC)发生的关联,分析BCP双突变和HCC临床病理特征的关系。方法随机收集233例慢性HBV感染者的血清,其中80例为慢性乙型肝炎(CHB)患者、75例为LC患者、78例为HCC患者,并系统整理患者的常规检查和病理等资料。采用实时荧光定量聚合酶链反应(FQ-PCR)检测BCP双突,用特异性引物多重PCR扩增确定HBV基因型。用SPSS 11.0分析结果。结果 HBV基因型结果均为B和C型,分别在CHB和LC组,CHB和HCC组间分布差异有统计学意义(P<0.05),在LC和HCC组间分布差异无统计学意义(P>0.05),感染C基因型与LC和HCC发生相关(分别OR=2.73,95%CI=1.29～5.82;OR=2.00,95%CI=0.98～4.09)。BCP双突变也分别在CHB和LC组,CHB和HCC组间分布差异有统计学意义(P<0.05),在LC和HCC组间分布差异无统计学意义(P>0.05),双突变与LC和HCC发生相关(分别OR=1.91,95%CI=0.96～3.82;OR=2.05,95%CI=1.04～4.06)。BCP双突变和伴肝硬化的HCC相关(P<0.05)。结论感染HBV C基因型、BCP双突变可能均是LC和HCC发生的危险因素,BCP双突变可作为LC和HCC早期预警生物标记物。     

超声随访在肝硬化结节恶变筛查及诊断中的价值研究

目的:研究超声随访在肝硬化结节恶变筛查及诊断中的价值。方法:选取我院收治的乙肝后肝硬化患者83例,均采取超声检查,观察超声随访在肝硬化结节恶变筛查及诊断中的应用价值。结果:本组83例随访发现,出现肝硬化伴增生性结节患者演变小肝癌21例。增生性结节患者的增生性结节直径与小肝癌患者肿块直径比较,差异无统计学意义(P0.05)。增生性结节患者的回声情况与小肝癌患者比较,差异有统计学意义(P0.05)。超声随访发现,结节由112个增加至126个,结节数量增加。肝硬化结节14例,在超声引导下行肝穿刺活检,成功13例,失败1例,病理诊断肝硬化结节患者9例,肝癌患者3例,与超声的检查结果相同。结论:超声随访在肝硬化结节恶变的筛查诊断中具有较高的临床价值,可在早期提供较为准确的检查结果,帮助医师做出诊断,及早治疗以改善预后。     

UDP-glucuronosyltransferase 1A7 polymorphisms are associated with liver cirrhosis

Variations in the UDP-glucuronosyltransferase (UGT) 1A7 gene have been found to be related to the development of hepatocellular carcinoma (HCC). Since the pathogenesis of liver cirrhosis is not dissimilar to that of HCC, we hypothesized that UGT1A7 genetic polymorphisms may be associated with liver cirrhosis. PCR-restriction fragment length polymorphism was utilized to determine UGT for 1A7 genotypes for the 159 patients with liver cirrhosis and 263 gender/age matched controls. Simple logistic regression analysis revealed that significant risk factors for liver cirrhosis were (1) hepatitis B virus (HBV) infection, (2) hepatitis C virus (HCV) infection, (3) HBV infection plus HCV infection and (4) low-activity UGT1A7 genotypes. The results of further multivariate logistic regression confirmed these associations. Interaction of low-activity UGT1A7 genotypes and HBV (or HCV) infection produced an additive effect upon the risk for the development of liver cirrhosis [observed odds ratio (OR) (54.59) greater than the expected OR (18.05)]. UGT1A7 low/low genotype was also related to advanced liver cirrhosis (Child-Pugh classes C and/or B) (OR = 7.50, P = 0.009). This study demonstrates the novel findings that carriage of low-activity UGT1A7 genotypes represents a risk factor for the development and functional severity of liver cirrhosis.