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題名 | 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 |
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作者 | 李偉華; | 書刊名 | 醫學研究 |
卷期 | 10:3 1989.11[民78.11] |
頁次 | 頁163-172 |
分類號 | 414.82 |
關鍵詞 | 病毒肝炎; 肝硬化; 肝細胞癌; |
語文 | 中文(Chinese) |
中文摘要 | 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?—抗一過氧化氫?(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)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,727%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HBsAg局部陽性反應。慢性活動性肝炎52例,平均診斷年齡為25.1歲滿84.6%呈HBsAg陽性反應,26.9%呈HBsAg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HBsAg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)和腺包狀為主,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。此三例皆有複雜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。 |
英文摘要 | The immunopathlogic features of 128 hepatitis-B (including acute hepatitis-B, chronic persistent hepatitis (CPH), chronic lobular hepatitis (CLH) and chronic active hepatitis (CAH), 11post-necrotic cirrhosis and 14 hepatocellular carcinoma (HCC)) were reviewed and analysed from 1986 to 1987 at Tri-Service General Hospital. The expression of hepatitits-B surface antigen(HBsAg) and core antigen (HBsAg) were assessed on formalin-fixed and paraffinembedded 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 HBsAg. 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 HBsAg. The average age at diagnosis of 42 CLH was 23.4 years. 88.0% expressed positive immunoreactivity HBsAg. 47.6% expressed focal positive immunoreactivity for HBsAg. 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 HBsAg. The average age at diagnosis of 11 post-necrotic cirrhosis was 36.3years. 81.8 expressed positive imunoreactivity for HBsAg. 36.4% expressed focal positive immuoreactivity for HBsAg. The average age at diagnosis of 11 adult HCC was 50.6 years. The ration of male to female was 2.67:1. Two cases (18.2%) expressed focal weakly positive immunoreactivity for HBsAg. 72.74% 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 occurring in adolescence and childhood were analyzed. 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 alpheto protein were detected in the serum examination. No evidence of cirrhosis was identified. All were dead with a grave prognosis. |
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