原发性胆汁性肝硬化所致肝癌患者自身抗体特征分析

目的 探讨原发性胆汁性肝硬化（PBC）合并原发性肝癌（HCC）患者的自身抗体特征分析.方法 回顾性分析2007-2012年于我院住院治疗PBC患者350例,对这些患者抗线粒体抗体（AMA）、抗线粒体抗体M2亚型（AMA-M2）、抗核抗体（ANA）、抗平滑肌抗体（SMA）、抗肝肾微粒体抗体（LKM）滴度及ANA的核型分析.结果 350例PBC患者发展为肝癌为2.57%（9/350）,其中女性患者2.38%（7/293）,男性患者3.5%（2/57）,9例患者中有7例可见AFP值升高,8例患者可见AMA、AMA-M2阳性,50%呈AMA高滴度（≧1：320）阳性.100%患者ANA检测结果阳性,88.9%患者滴度以高滴度为主（≧1：320）.ANA核型以混合核型为主.抗核抗体谱检测可见3例患者分别为CENPB、SSA、Scl-70阳性,2例患者gp210阳性.结论 PBC患者中有2.57%发展为HCC,自身抗体检测情况与PBC患者类似.多数患者可检测出高滴度的AMA、AMA-M2及ANA,这些患者ANA核型以混合核型为主,患者血清AFP值与自身抗体有一定相关性,可能提示血清AFP值与自身免疫反应强弱相关.

The characteristic of auto-antibodies of hepatocellular carcinoma in primary biliary cirrhosis

Objective To study the characteristic of autoantibodies on primary biliary cirrhosis patients with hepato- cellular carcinoma. Methods Retrospectively analyzed 350 cases of PBC patients from 2007 to 2012. Analyze the titer of anti-mitochondral antibodies（AMA） ,subtype 2 of AMA（M2）,anti-nuclear antibodies（ANA） ,anti-smooth muscle anti bodies（SMA） ,anti-liver kidney microsomal antibody（LKM）, anti-centromere antibodies（ACA） and examined the main fluorescent patterns of ANA of those patients. Results According to the date of all reviewed PBC patients,the HCC in- cidence was 2.57/oo（9/350）. The incidence by gender was 2.38%（7/293） in female and 3.5/00（2/57） in male. 7 cases of the 9 patients with high level of AFP. 8 cases were positive for AMA,M2,50 of them showed high titer of AMA（ _-〉 1：320）. 100% of them were ANA positive,88.9% of them showed high titer of ANA（ _-〉 1：320）o The major fluores- cent patterns of ANA is mixed patterns. ENA profiles detected 3 cases positive, respectively CENP B, SS-A, Scl-70. gp210 positive in 2 patients. Conclusion 2. 570//00 of PBC patients developed into HCC. The resuJts of auto-antibodies detection are similar to PBC,most of the patients have high level of AMA, M2 and ANA,major patients present mix fluorescent patterns of ANA. Serum AFP level has a certain correlation with anto-antibodies,this phenomenon may in- dicate serum AFP value associated with patients autoimmune reaction.