- 期刊
- OpenAccess
以免疫病理學研究HBsAg與HBcAg在B型病毒肝炎，肝硬化及肝細胞癌之表現
Immunopathologic Study of the Expression of HBsAg and HBcAg on Hepatitis B Virus Infections, Cirrhosis and Hepatocellular Carcinoma
摘要
本文乃以客觀組織診斷標準，重新分類128例B型肝炎，11例肝硬化及14例肝細胞癌。並以過氧化氫酶－抗－過氧化氫酶（PAP）免疫組織化學染色法，測試B型肝炎表面抗原（HBsAg）與核心抗原（HBcAg）在B型肝炎、肝硬化及肝細胞癌組織中之分佈狀況。急性肝炎23例，平均診斷年齡為23.6歲，69.6%呈HBsAg陽性反應，13.3%呈HBcAg 局部陽性反應。慢性持續性肝炎11例，平均診斷年齡為23.8歲，72.7%呈HBsAg陽性反應。27.3%呈HBcAg局部陽性反應。慢性小葉性肝炎42例，平均診斷年齡為23.4歲，88.0%呈HBsAg陽性反應，47.6%呈HBcAg局部陽性反應。慢性活動性肝炎52例，平均診斷年齡為25.1歲，84.6%呈HBsAg陽性反應，26.9%呈HBcAg陽性反應。肝硬化11例，平均診斷年齡為36.3歲，81.8%呈HBsAg陽性反應，36.4%呈HBcAg局部陽性反應。成人型肝細胞癌11例，平均診斷年齡為50.6歲。男女性別之比為2.67：1。其中2例（18.2%）呈HBsAg局部陽性反應，72.7%合併肝硬化現象。其組織學變化以小樑狀（血竇樣狀）和腺泡狀為主，且嗜侵犯血管組織。青少年與小孩型肝細胞癌佔3例，其性別與年齡分別為男性／13歲，男性／19歲，女性／13歲。此3例皆有複雜B型肝炎家族感染史。臨床上血清學檢查含大量甲型胎兒蛋白質（α-FP）。3例無肝硬化現象且皆已死亡，預後甚差。
並列摘要
The immunopathologic features of 128 hepatitis-B (including acute hepatitis-B, chronic persistent hepatitis (CPH), chronic lobular hepatitis (CLH) and chronic active hepatitis (CAH), II post-necrotic cirrhosis and 14 hepatocellular carcinoma (HCC)) were reviewed and analysed from 1986 to 1987 at Tri-Service General Hospital. The expression of hepatitis-B surface antigen (HBsAg) and core antigen (HBcAg) were assessed on formalin-fixed and paraffin embedded sections by immunohistochemical peroxidase-anti-peroxidase (PAP) assays. The average age at diagnosis of 23 acute hepatitis-B was 23.6 years. 69.6% expressed positive immunoreactivity for HBsAg. 13.3% expressed focal positive immunoreactivity for HBcAg. The average age at diagnosis of 11 CPH was 23.8 years. 72.7% expressed positive immunoreactivity for HBsAg. 27.3% expressed focal positive immunoreactivity for HBcAg. The average age at diagnosis of 42 CLH was 23.4 years. 88.0% expressed positive immunoreactivity for HBsAg. 47.6% expressed focal positive immunoreactivity for HBcAg. The average age at diagnosis of 52 CAH was 25.1 years. 84.6% expressed positive immunoreactivity for HBsAg 26.9% expressed focal positive immunoreactivity for HBcAg. The average age at diagnosis of 11 post-necrotic cirrhosis was 36.3 years. 81.8% expressed positive immunoreactivity for HBsAg. 36.4% expressed focal positive immunoreactivity for HBcAg. The average age at diagnosis of 11 adult HCC was 50.6 years. The ratio of male to female was 2.67: 1. Two cases (18.2%) expressed focal wealky positive immunoreactivity for HBsAg. 72.7% of HCC were associated with cirrhosis. The trabecular (sinusoidal) and acinar (tubular) patterns were the two main histologic features of HCC. All patterns of HCC had a strong propensity for invasion of vascular channels. Three cases of HCC occuring in adolescence and childhood were analysed. The sex and age was male/13 years, male/19 years, and female/13 years respectively. Those cases had complex family history of chronic hepatitis-B infection. Large amount of alpafeto protein were detected in the serum examination. No evidence of cirrhosis was identified. All were dead with a grave prognosis.