Introduction

utoan tibodies, the important diagnostic criterion for autoimmune diseases, could be found in several malignant tumors such as leukemia, breast cancer lung carcinoma, and nasopharyngeal carcinoma. Primary hepatocarcinoma (PHC) is one of them. There are few reports on detecting autoantibodies in PHC patients. In this research, we focused on the significance in detecting autoantibodies of PHC patients.

Methods

Patients

A total of 139 patients with PHC (123 were male and 16 female, aged 25-76) were studied. The diagnosis of PHC was based on ultrasonographic, CT, histological findings and serum alpha-fetoprotein (AFP) levels. As a control group, plasma of blood donors was collected from the Shanghai Blood Bank Center, Shanghai.

Antigens and antibodies

Antigens and antibodies of HBV were determined by enzyme immune assay (Kehua Biotech Co., Ltd, Shanghai, China). Antibody to HCV IgG was detected by enzyme-Linked immunoabsorbent assay, for tune Long March-Trace Medical Science Co, Ltd., Shanghai, China).

Autoantibodies

Autoantibodies were tested by indirect immunofluorescence using commercial Biochip slides (Euroimmun, Germany), kindly provided by Dr. Stoecker. Biochip sLides were covered by human Hep-2 cell and frozen sections of different tissues including monkey liver, heart, rat liver, Kidney and stomach. Serum and plasma were diluted by PBS-Tween. The assay was performed essentially according to the processing instruction. Autoantibodies were made visible with the LEICA DMLS fluorescence microscope.

Statistical analysis

Pearson’s χ² test was used for comparison.

Results

38 (38/139, 27.3%) patients were autoantibodies Positive at a 1∶100 or higher dilution. The results of autoantibody patterns and HBV antigens or antibodies are listed in Table 1.

All patients were negative for anti-HCV-IgG. Normal (<40 U/L) and abnormal ALT results were observed in 35 (25.2%) and 104 (74.8%) patients, respectively. All of the blood donors were negative for antigens or antibodies of HBV and HCV, and all of ALT were normal.

In 50 blood donors, 2 (4%) with Positive autoantibodies showed a significant difference from PHC patients (P<0.01) . Moreover, 26 of the 38 autoantibody positive patients showed abnormal ALT, but 81 of 101 autoantibody negative patients showed abnormal ALT (P>0.05) .

Discussion

Autoantibodies were found in 38 of 139 , 27.3%, PHC patients. 34 had a history of HBV infection. It is shown that a significant difference between chronic HBV infection (9.5%) and PHC patients. In the 38 autoantibody positive PHC patients, 4 (10.5%) had no evidence of HBV infection. It is suggested that autoantibody detection in PHC patients is of significance in studying the occurrence mechanism of autoimmune reaction and etiologIcal factors of PHC.

Many patterns of autoantibody exist in PHC. Anti-nuclear antibody (ANA) is the most frequen one with homogeneous, nuclear speckled and nucleolar distribution. In our study, 36 of the 38 (94.7%) autoantibody positive patients were ANA positive, suggesting that ANA is the major pattern in PHC. Other patterns were also observed: anti-smooth muscle antibody(ASMA), anti-mitochondria antibody, anti-midbody antibody and anti-liver cell membrane antibody, which could occur simultaneously with ANA in the same patient.

The diversity types of autoantibody might resulted from a wide variety of etiological factors for PHC development such as necrosis, viruses, alcohol and mold, and from a wide variety of overexpressed or mutated proteins involved in repeated cycles of necrosis and regeneration in hepatocarcinoma development.^[1]

Reference

1 Covini G, von Muhlen GA, Pacchetti S, et al. Diversity of antinuclear antibody responses in hepatocellulae carcinoma. J Hepatol 1997;26:1255-1265.

(Accepted August 31, 2001)