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为探讨丙型肝炎病毒(HCV)在肝组织的分布及可能的致病机理,用地高辛标记的HCV5′-NC区cDNA探针和抗HCVC33c单克隆抗体对经血清抗HCV和HCVRNA检测证实的24例HCV感染的慢性肝病患者肝组织进行原位核酸杂交和免疫组化研究。结果显示:肝组织HCVRNA和C33c阳性率分别为58.3％,79.2％,两项阳性率无显著性差异(X~2=0.178,P>0.5)。17例血清HCVRNA和抗HCV均阳性者中,肝组织HCVRNA阳性14例,C33c阳性为15例。7例血清单项抗HCV阳性者没有检出HCVRNA,但4例C33c阳性。HCV RNA和C33c阳性信号主要定位于肝细胞浆或肝癌细胞浆内。HCV感染的阳性肝细胞呈散在、局灶和弥漫三种形式分布,与ALT水平,肝组织学类型没有明显联系。HCV感染的细胞周围有较多的淋巴细胞和单核细胞浸润。提示HCV在肝细胞浆增殖复制,引起宿主的免疫反应,在HCV感染的慢性肝病发病机理中起重要作用,同时检测血清抗HVC和HCVRNA可提高HCV感染的确诊率,免疫组化检测C33c与原位杂交检测HCVRNA有同样的敏感性,但方法简便、更适应用于临床。
To investigate the distribution and possible pathogenic mechanism of hepatitis C virus (HCV) in liver tissue, we used Digoxigenin-labeled HCV 5’-NC region cDNA probe and anti-HCVC33c monoclonal antibody to detect the serum anti-HCV and HCV RNA Twenty-four patients with HCV-infected chronic liver disease were subjected to in situ hybridization and immunohistochemistry. The results showed that the positive rates of HCV RNA and C33c in liver tissue were 58.3% and 79.2%, respectively. There was no significant difference between the two positive rates (X ~ 2 = 0.178, P> 0.5). Of the 17 patients with positive serum HCV RNA and anti-HCV, 14 were positive for HCVRNA in liver tissue and 15 were positive for C33c. No HCV RNA was detected in 7 cases of anti-HCV positive in serum, but 4 cases were positive in C33c. HCV RNA and C33c-positive signals are mainly localized in the cytoplasm of hepatocytes or liver cancer cells. Positive HCV-infected hepatocytes were scattered, focal and diffuse distribution of three forms, and ALT level, liver histology type is not significantly linked. There is more lymphocyte and monocyte infiltration around HCV-infected cells. It is suggested that HCV can proliferate and replicate in the cytoplasm of the liver and cause host immune response, which plays an important role in the pathogenesis of chronic liver disease with HCV infection. Simultaneous detection of serum anti-HVC and HCVRNA can improve the diagnosis of HCV infection. Immunohistochemical detection of C33c and original The detection of HCVRNA by the hybridization has the same sensitivity, but the method is simple and suitable for clinical use.