摘要目的 探讨HBcAg在慢性HBV感染者肝细胞内的分布情况及其临床意义.方法 对41例慢性HBV感染者进行肝组织穿刺,用免疫荧光组织化学技术在激光共聚焦显微镜下观察肝细胞内HBcAg的分布情况.计量资料采用Kruskal Wallis检验,计数资料采用卡方检验.结果 41例慢性HBV感染者中,36例肝细胞内HBcAg阳性表达,阳性率为87.8%,其中23例肝功能中度异常,10例肝功能轻度异常,3例肝功能正常.HBcAg有膜、胞质与核三种形式表达.在23例肝功能中度异常者中,6例呈明显膜型表达,无明显胞质型及核型,17例以胞质型与膜型混合表达,未发现核型表达.在10例肝功能轻度异常者中,以单纯胞质型为主,未见膜型与核型表达.在3例肝功能正常者中,以胞质型表达与少许核型表达为主,未见膜型表达.HBcAg表达类型与肝功能之间差异有统计学意义(χ2=10.60,P＜0.01).结论 慢性HBV感染者肝组织损伤与HBcAg的表达有直接联系,提示膜型表达的HBcAg是肝脏免疫损伤过程中的靶抗原.

abstractsObjective To explore the distribution and clinical significance of hepatitis B core antigen( HBcAg) in the hepatocytes of chronic hepatitis B virus infected patients. Methods Paraffin sections were made from 41 liver biopsy samples obtained from chronic hepatitis B virus infected patients. The immuno-fluorescence confocal technique was utilized to analyze the expression level and localization of HBcAg in hepatocytes. The data were analyzed by using Kruskal Wallis test and chisquare test. Results HBcAg expression were detected in 36 (87. 8%) patients, among whom 23 cases had moderate abnormal liver function, 10 with mild abnormal liver function and 3 with normal liver function. Among the cases with moderate abnormal liver function, 6 cases showed the simple membrane-type HBcAg expression, 17 cases showed mixed cytosolic-type and membrane-type HBcAg expression without the nuclear-type expression. Twelve cases with mild abnormal liver function only showed simple cytosolic-type HBcAg expression without membrane-type or nuclear-type expression. In the three patients with normal liver function, HBcAg was expressed in cytoplasm and nuclear but not on membrane. The correlation between HBcAg expression pattern and liver function was statistically significant (χ2 =10. 60, P＜0.01). Conclusion HBcAg expression is directly correlated with liver injury in chronic hepatitis B virus infected patients, which indicates that membrane expressed HBcAg is the target antigen during the immuno-attack of liver.