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为了探讨丙型肝炎病毒（ＨＣＶ）感染与肝细胞癌（ＨＣＣ）的关系以及ＨＣＶ可能的致癌机理，采用免疫组织化学方法及巢式ＰＣＲ法检测了１３６例肝细胞癌等肝病组织中的ＨＣＶＮＳ３抗原、ＨＣＶＲＮＡ及Ｐ２１、Ｐ５３蛋白。结果表明，肝细胞癌及癌周肝组织中有ＨＣＶＮＳ３抗原及ＨＣＶＲＮＡ检出，支持ＨＣＶ与ＨＣＣ的关联。Ｐ２１在ＨＣＣ、肝炎后肝硬化、慢性肝炎、体质性黄疸各组中的检出率随病变的加重而逐渐增高，在ＨＣＣ的癌及癌周组织中Ｐ２１呈致密的过量表达，提示ｒａｓ癌基因的激活在ＨＣＣ的发生过程中起一定作用。Ｐ５３的阳性率较Ｐ２１低，但ｐ５３的突变似乎也是肝癌发生的协同因素之一。组织中Ｐ２１的过量表达与ＨＣＶＮＳ３抗原阳性检出呈正相关，ＨＣＶＮＳ３抗原与Ｐ２１的这种关联提示，ＨＣＶ感染作为ＨＣＣ的密切相关因素之一，可能通过激活某些癌基因或使某些抑癌基因突变而致肝细胞癌变
In order to investigate the relationship between hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC) and the possible carcinogenic mechanism of HCV, immunohistochemistry and nested PCR were used to detect HCV NS3 antigen in 136 cases of hepatocellular carcinoma , HCVRNA and P21, P53 protein. The results showed that HCV NS3 antigen and HCV RNA were detected in hepatocellular carcinoma and pericancerous liver tissues, supporting the association between HCV and HCC. The detection rate of P21 in HCC, posthepatitic cirrhosis, chronic hepatitis, and constitutional jaundice gradually increased with the increasing of pathological changes. P21 was overexpressed in cancerous and perinuclear tissues of HCC, suggesting that ras oncogene Activation plays a role in the occurrence of HCC. The positive rate of P53 is lower than that of P21, but the mutation of p53 seems to be one of the synergistic factors of HCC. Overexpression of P21 in tissues was positively correlated with positive detection of HCV NS3 antigen. The association of HCV NS3 antigen with P21 suggests that HCV infection, as one of the closely related factors in HCC, may activate some oncogenes or make certain tumor suppressor genes Mutation caused by hepatocellular carcinoma