Batskikh Sergey, Morozov Sergey, Kostyushev Dmitry
Department of Hepatology, Moscow Clinical Research Center named after A.S. Loginov, Moscow 111123, Russia.
Department of Gastroenterology, Hepatology and Nutrition, Federal Research Center of Nutrition and Biotechnology, Moscow 115446, Russia.
World J Hepatol. 2022 Jul 27;14(7):1512-1519. doi: 10.4254/wjh.v14.i7.1512.
Hepatitis B virus (HBV) is a known carcinogen that may be involved in pancreatic cancer development. Detection of HBV biomarkers [especially expression of HBV regulatory X protein (HBx)] within the tumor tissue may provide direct support for this. However, there is still a lack of such reports, particularly in non-endemic regions for HBV infection. Here we present two cases of patients with pancreatic ductal adenocarcinoma, without a history of viral hepatitis, in whom the markers of HBV infection were detected in blood and in the resected pancreatic tissue.
The results of examination of two patients with pancreatic cancer, who gave informed consent for participation and publication, were the source for this study. Besides standards of care, special examination to reveal occult HBV infection was performed. This included blood tests for HBsAg, anti-HBc, anti-HBs, HBV DNA, and pancreatic tissue examinations with polymerase chain reaction for HBV DNA, pregenomic HBV RNA (pgRNA HBV), and covalently closed circular DNA HBV (cccDNA) and immunohistochemistry staining for HBxAg and Ki-67. Both subjects were operated on due to pancreatic ductal adenocarcinoma and serum HBsAg was not detected. However, in both of them anti-HBc antibodies were detected in blood, although HBV DNA was not found. Examination of the resected pancreatic tissue gave positive results for HBV DNA, expression of HBx, and active cellular proliferation by Ki-67 index in both cases. However, HBV pgRNA and cccDNA were detected only in case 1.
These cases may reflect potential involvement of HBV infection in the development of pancreatic cancer.
乙型肝炎病毒（HBV）是一种已知的致癌物，可能参与胰腺癌的发生发展。在肿瘤组织中检测HBV生物标志物[尤其是HBV调节X蛋白（HBx）的表达]可能为此提供直接证据。然而，目前仍缺乏此类报道，尤其是在HBV感染非流行地区。在此，我们报告两例胰腺导管腺癌患者，他们无病毒性肝炎病史，但在血液和切除的胰腺组织中检测到了HBV感染标志物。
本研究来源于两名签署了参与研究及发表同意书的胰腺癌患者的检查结果。除了常规护理标准外，还进行了特殊检查以发现隐匿性HBV感染。这包括检测血液中的HBsAg、抗-HBc、抗-HBs、HBV DNA，以及对胰腺组织进行HBV DNA、前基因组HBV RNA（pgRNA HBV）和共价闭合环状DNA HBV（cccDNA）的聚合酶链反应检测，以及对HBxAg和Ki-67进行免疫组织化学染色。两名患者均因胰腺导管腺癌接受手术，血液中未检测到血清HBsAg。然而，两人血液中均检测到抗-HBc抗体，尽管未发现HBV DNA。对切除的胰腺组织进行检查，两例患者的HBV DNA、HBx表达以及通过Ki-67指数检测的活跃细胞增殖均呈阳性结果。然而，仅在病例1中检测到HBV pgRNA和cccDNA。
这些病例可能反映了HBV感染在胰腺癌发生发展中的潜在作用。
