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目的探讨乙型肝炎病毒（ＨＢＶ）与肝细胞癌（ＨＣＣ）的关系。方法采用直接原位聚合酶链反应（ｉｎｓｉｔｕＰＣＲ，ＩＳＰＣＲ），对６４例福尔马林固定石蜡包埋的ＨＣＣ组织（其中６１例附癌周组织）切片中的ＨＢＶＤＮＡ进行检测，并与传统的免疫组织化学原位杂交和组织抽提核酸ＰＣＲ法进行了比较。结果ＩＳＰＣＲ对石蜡包埋的ＨＣＣ组织中的ＨＢＶＤＮＡ检测高度敏感，检出率为７１．９％（４６／６４），而相应组织应用免疫组织化学法（ＨＢｓＡｇ）、原位杂交和组织抽提核酸ＰＣＲ法的结果分别为１７．２％（１１／６４）、５４．７％（３５／６４）和５７．８％（３７／６４）。癌周组织中的ＨＢＶＤＮＡ的检出率明显高于癌组织者，为７８．７％（４８／６１）。ＩＳＰＣＲ检测还显示，ＨＢＶＤＮＡ在肝细胞与癌细胞中主要分布于胞浆，较少见于胞核。在癌组织中，核阳性占４８．４％（３１／６４），癌周组织中则为２４．６％（１５／６１）。结论ＨＢＶＤＮＡ在癌周及癌组织存在情况的复杂性提示ＨＢＶ的感染、整合在ＨＣＣ发生中的作用远非清楚。
Objective To investigate the relationship between hepatitis B virus (HBV) and hepatocellular carcinoma (HCC). METHODS: HBV DNA was detected in 64 formalin-fixed paraffin-embedded HCC specimens (61 of the adenocarcinoma tissues) using direct in situ polymerase chain reaction (ISPCR) and compared with conventional immunization. Histochemical in situ hybridization and tissue extraction nucleic acid PCR methods were compared. Results ISPCR was highly sensitive to the detection of HBV DNA in paraffin-embedded HCC tissues. The detection rate was 71.9% (46/64). The corresponding tissues were subjected to immunohistochemistry (HBsAg), in situ hybridization and tissue extraction of nucleic acids. The PCR results were 17.2% (11/64), 54.7% (35/64), and 57.8% (37/64), respectively. The detection rate of HBV DNA in the cancer tissue was significantly higher than that in the cancer tissue, which was 78.7% (48/61). ISPCR detection also showed that HBV DNA is mainly distributed in the cytoplasm in liver cells and cancer cells, and is rarely seen in the nucleus. In cancerous tissues, nuclear positives accounted for 48.4% (31/64) and in cancerous tissues 24.6% (15/61). Conclusion The complexity of HBV DNA in the presence of cancer and cancer suggests that the role of HBV infection and integration in the development of HCC is far from clear.