Zhou X D, DeTolla L, Custer R P, London W T
Cancer. 1987 Apr 15;59(8):1430-7. doi: 10.1002/1097-0142(19870415)59:8<1430::aid-cncr2820590808>3.0.co;2-a.
Surgically resected specimens, consisting of tumor and adjacent non-neoplastic liver tissue, were obtained from 40 patients with primary liver cancer at Zhong Shan Hospital, Shanghai Medical University, the People's Republic of China, between March 1983 and July 1984. All were hepatocellular carcinomas (HCC), one being admixed with cholangiocarcinoma. The relationship of hepatitis B virus (HBV) markers with iron and ferritin was evaluated in liver tissues from patients with primary liver cancers. The serum HBsAg (Hepatitis B surface antigen) positive rate was 80.0% (32/40). Cirrhosis was observed in 97.5% (39/40). HBsAg was identified in 82.5% (33/40) of uninvolved liver, and 35.0% (14/40) of HCC tissues (P less than 0.001). HBcAg (hepatitis B core antigen) was detected in 25.0% (10/40) of liver, and 7.5% (3/40) of HCC tissues (P less than 0.05). Stainable iron was found in 65.0% (26/40) of unaffected livers, and 10.0% (4/40) of HCC tissues (P less than 0.001). Ferritin was demonstrated in 75% (30/40) of non-neoplastic liver, and 40% (16/40) of HCC tissues (P less than 0.001). Twenty-two of 33 HCC patients (66.7%) with HBsAg positive cells in their livers also showed stainable iron. Of 16 patients positive for ferritin in HCC cells, iron was found in only two. Iron was found in nine of ten patients with HBcAg in non-neoplastic hepatocytes (P = 0.056); a finding compatible with the hypothesis that iron accumulates in cells replicating HBV. The other results indicate that: immunohistologic ferritin in HCC is not due to increased stainable iron; tumor cells may produce ferritin; polyclonal antibodies to human liver ferritin react better with non-neoplastic hepatocytes than with HCC cells; the high prevalence of HBsAg and cirrhosis in HCC suggests that HBV plays a major etiologic role in hepatocarcinogenesis in China; and one case of HCC is attributed to Schistosoma japonicum infestation via cirrhosis.
1983年3月至1984年7月期间，从中华人民共和国上海医科大学中山医院的40例原发性肝癌患者身上获取了手术切除标本，标本包括肿瘤组织及相邻的非肿瘤性肝组织。所有病例均为肝细胞癌（HCC），其中1例混合有胆管癌。对原发性肝癌患者肝组织中乙型肝炎病毒（HBV）标志物与铁及铁蛋白的关系进行了评估。血清乙肝表面抗原（HBsAg）阳性率为80.0%（32/40）。97.5%（39/40）的病例观察到肝硬化。在未受累肝组织中，82.5%（33/40）检测到HBsAg，而在HCC组织中为35.0%（14/40）（P<0.001）。在25.0%（10/40）的肝组织及7.5%（3/40）的HCC组织中检测到乙肝核心抗原（HBcAg）（P<0.05）。在65.0%（26/40）的未受影响肝组织及10.0%（4/40）的HCC组织中发现可染色铁（P<0.001）。在75%（30/40）的非肿瘤性肝组织及40%（16/40）的HCC组织中检测到铁蛋白（P<0.001）。33例肝组织中有HBsAg阳性细胞的HCC患者中，22例（66.7%）也显示有可染色铁。在HCC细胞中铁蛋白阳性的16例患者中，仅2例发现有铁。在10例非肿瘤性肝细胞中有HBcAg的患者中，9例发现有铁（P = 0.056）；这一发现与铁在复制HBV的细胞中蓄积的假说相符。其他结果表明：HCC中免疫组织化学检测到的铁蛋白并非由于可染色铁增加；肿瘤细胞可能产生铁蛋白；抗人肝铁蛋白的多克隆抗体与非肿瘤性肝细胞的反应比与HCC细胞的反应更好；HCC中HBsAg和肝硬化的高发生率表明HBV在中国肝癌发生中起主要病因作用；1例HCC归因于日本血吸虫感染导致的肝硬化。
