论文部分内容阅读
目的：探讨慢性肝炎、肝硬化和原发性肝癌患者血清中自身抗体的变化规律。方法：收集３４２例慢性肝病和肝癌血清标本，以 Ｈｅｐ－２细胞和猴肝组织为抗原基质，采用间接免疫荧光法检测自身抗体。结果：慢性肝炎、肝硬化、肝癌患者抗核抗体（ＡＮＡ）的阳性检出率分别为２１．８％（３５／１６０），２７．５％（３０／１０９）和３４．２％（２５／７３），均明显高于对照组的３％（６／２００）。３组ＡＮＡ核型种类较多，但均以颗粒型为主。以蛋白质印迹法检测抗可提取性核抗原（ＥＮＡ）抗体。发现４０例ＡＮＡ颗粒型的患者，有１２例ｎＲＮＰ／Ｓｍ和（或）ＳＳＡ阳性，３例Ｓｃｌ－７０和２例Ｊｏ－１阳性；１５例ＡＮＡ均质型有７例为抗双链ＤＮＡ抗体和１例抗组蛋白抗体。对照组中２例ＡＮＡ颗粒型分别为ｎＲＮＰ／Ｓｍ和ＳＳＡ阳性。３组病例的胞质抗体有多种，以抗线粒体抗体阳性率最高，肝硬化和肝癌组分别达１２．８％和１２．３％；慢性肝炎组为８．９％。结论：慢性肝炎、肝硬化、肝癌患者血清中不仅存在着自身抗体，而且显著高于正常人。ＡＮＡ的靶抗原中除一部分是目前已鉴定的外，大部分有待于进一步鉴定。
Objective: To investigate the changes of serum autoantibodies in patients with chronic hepatitis, liver cirrhosis and primary liver cancer. METHODS: A total of 342 serum samples of chronic liver disease and hepatocellular carcinoma were collected. Hep-2 cells and monkey liver tissues were used as the antigen matrix. Autoantibodies were detected by indirect immunofluorescence. Results: The positive detection rates of antinuclear antibody (ANA) in patients with chronic hepatitis, liver cirrhosis and liver cancer were 21.8% (35/160), 27.5% (30/109) and 34.2% (25/ 73), significantly higher than 3% (6/200) of the control group. There were many ANA karyotypes in the three groups, but all were mainly granular. Western blotting was used to detect anti-extractable nuclear antigen (ENA) antibodies. Of the 40 patients with ANA granulomatous type, 12 were positive for nRNP/Sm and/or SSA, 3 were positive for Scl-70, and 2 were Jo-1; 15 of 7 ANA homozygous were anti-double-stranded DNA antibodies. And 1 case of anti-histone antibody. Two ANA granules in the control group were positive for nRNP/Sm and SSA, respectively. There were many kinds of cytoplasmic antibodies in three groups, with the highest positive rate of anti-mitochondrial antibody, 12.8% in cirrhosis and 12.3% in liver cancer, and 8.9% in chronic hepatitis. Conclusion: There are not only autoantibodies in the serum of patients with chronic hepatitis, liver cirrhosis and liver cancer, but also significantly higher than normal people. In addition to part of the ANA’s target antigen is currently identified, most of them need further identification.