Brief Articles
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World J Gastroenterol. Apr 7, 2009; 15(13): 1636-1640
Published online Apr 7, 2009. doi: 10.3748/wjg.15.1636
B-cell clonality in the liver of hepatitis C virus-infected patients
He-Bin Fan, You-Fu Zhu, An-Shen Chen, Mu-Xiu Zhou, Fu-Ming Yan, Xiao-Ju Ma, Hao Zhou
He-Bin Fan, An-Shen Chen, Fu-Ming Yan, Xiao-Ju Ma, Hao Zhou, Department of Infectious Disease, The People’s Liberation Army 161 Hospital, Wuhan 430010, Hubei Province, China
You-Fu Zhu, Department of Infectious Disease, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Mu-Xiu Zhou, Department of Pathology, The People’s Liberation Army 161 Hospital, Wuhan 430010, Hubei Province, China
Author contributions: Fan HB, Zhu YF, Chen AS and Zhou MX performed the majority of experiments; Zhu YF provided vital reagents and analytical tools and was also involved in the collecting of all the human material; Yan FM, Ma XJ, Zhou H edited the manuscript.
Correspondence to: Dr. He-Bin Fan, Department of Infectious Disease, The People’s Liberation Army 161 Hospital, Wuhan 430010, Hubei Province, China. fan_hebin@126.com
Telephone: +86-27-50169074
Fax: +86-27-50169007
Received: January 12, 2009
Revised: February 22, 2009
Accepted: March 1, 2009
Published online: April 7, 2009
Abstract

AIM: The association of hepatitis C virus (HCV) infection with type II mixed cryoglobulinemia is well established, but the role of HCV in B-cell lymphoma remains controversial. In patients with HCV infection, B-cell clonal expansions have been detected in peripheral blood and bone marrow, and a high prevalence of B-cell non-Hodgkin’s lymphomas has been documented. Liver biopsies in chronic HCV infection frequently show portal lymphoid infiltrates with features of B follicles, whose clonality has not yet been investigated. The object of this study was to determine the frequency of liver-infiltrating monoclonal B-cells in 40 patients with HCV infection.

METHODS: Eight hundred and forty-eight patients were studied prospectively, including 40 HCV-positive patients and 808 patients with chronic hepatitis B virus (HBV) infection. Immunohistochemical study for B- and T-cell markers was performed on the paraffin-embedded liver tissue sections. The clonality of lymphoid B-cells was tested using a polymerase chain reaction (PCR) approach designed to identify immunoglobulin heavy chain gene (IgH) rearrangements.

RESULTS: Liver-infiltrating monoclonal B-cells were detected in the liver for 4 (10%) of 40 HCV-positive patients but were present in only 3 (0.37%) of 808 liver biopsy specimens with chronic HBV infection. Chi-square testing showed that the monoclonal B-cells infiltration in the liver was more frequent in the HCV-infected patients (P = 0.000). A clonal IgH rearrangement was detected in 5 (71.4%) of 7 liver biopsy specimens with monoclonal B-cells infiltration. In 2 of 5 patients with both a clonal B-cell expansion and monoclonal B-cells infiltration in the liver, a definite B-cell malignancy was finally diagnosed.

CONCLUSION: Liver-infiltrating monoclonal B-cells are detected in the liver of patients with chronic HCV and HBV infection. A high percentage of patients with monoclonal B-cells infiltration and B-cell clonality in the liver were finally diagnosed as having a definite B-cell malignancy.

Keywords: Hepatitis, Hepatitis C virus, B-lymphocytes, Polymerase chain reaction, Gene rearrangement, Clonality