Liao Wei-Hsuan, Tung Shui-Yi, Shen Cheng-Han, Lee Kam-Fai, Wu Cheng-Shyong
Division of Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Chang Gung Med J. 2011 May-Jun;34(3):260-7.
In chronic hepatitis B, the HBcAg viral protein in liver tissue demonstrates a positive correlation with serum aminotransferase levels, serum hepatitis B viral DNA, and histological activities. Little is known if similar relationships exist for chronic hepatitis C. This study attempted to determine if expression of the hepatocyte NS3 protein of the hepatitis C virus (HCV-NS3) was correlated with the serum HCV-RNA load, hepatitis activity, or other clinical parameters.
Clinical and histological data of 214 patients with chronic hepatitis C were retrospectively reviewed. A mouse monoclonal antibody was used to detect HCV-NS3 in hepatocytes. The staining intensity was scored semiquantitatively as 0~3+, and its correlations with the serum HCV-RNA load, hepatitis activity, and other clinical parameters were analyzed.
In total, 202 (94%) of the 214 liver biopsies were positive for HCV-NS3, and the intensity of HCV-NS3 staining was 0 in 12 (6%), 1+ in 181 (84%), and 2+ in 21 patients (10%). The intensity of HCV-NS3 expression in the samples did not correlate with patient age (p = 0.302, ANOVA), patient gender (p = 0.130, Fisher's exact test), the alanine transaminase level (p = 0.177, ANOVA), serum HCV-RNA level (p = 0.305, ANOVA), HCV antibody titer (p = 0.139, Chi-squared test), hepatitis activity index score (p = 0.861, Chisquared test), or sustained viral response rate (p = 0.861, Chi-squared test).
This HCV-NS3 immunohistochemical staining method was reliable for detecting HCV in liver specimens. Hepatocyte expression of HCV-NS3 was not correlated with the serum viral load, severity of hepatic injury, or treatment response.
在慢性乙型肝炎中，肝组织中的乙肝核心抗原（HBcAg）病毒蛋白与血清转氨酶水平、血清乙型肝炎病毒DNA及组织学活性呈正相关。对于慢性丙型肝炎是否存在类似关系，人们知之甚少。本研究试图确定丙型肝炎病毒（HCV）的肝细胞NS3蛋白表达是否与血清HCV-RNA载量、肝炎活动度或其他临床参数相关。
回顾性分析214例慢性丙型肝炎患者的临床和组织学资料。采用小鼠单克隆抗体检测肝细胞中的HCV-NS3。染色强度进行半定量评分，为0~3+，并分析其与血清HCV-RNA载量、肝炎活动度及其他临床参数的相关性。
214例肝活检标本中，共有202例（94%）HCV-NS3呈阳性，HCV-NS3染色强度为0的有12例（6%），1+的有181例（84%），2+的有21例（10%）。样本中HCV-NS3的表达强度与患者年龄（p = 0.302，方差分析）、患者性别（p = 0.130，Fisher精确检验）、丙氨酸转氨酶水平（p = 0.177，方差分析）、血清HCV-RNA水平（p = 0.305，方差分析）、HCV抗体滴度（p = 0.139，卡方检验）、肝炎活动指数评分（p = 0.861，卡方检验）或持续病毒学应答率（p = 0.861，卡方检验）均无相关性。
这种HCV-NS3免疫组化染色方法在检测肝标本中的HCV时是可靠的。HCV-NS3在肝细胞中的表达与血清病毒载量肝损伤严重程度或治疗反应无关。
