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中国慢性丙型肝炎患者门静脉淋巴样聚集/滤泡的临床意义

Clinical significance of portal lymphoid aggregates/follicles in Chinese patients with chronic hepatitis C.

作者信息

Luo J C, Hwang S J, Lai C R, Lu C L, Li C P, Tsay S H, Wu J C, Chang F Y, Lee S D

机构信息

Department of Medicine, Veterans General Hospital-Taipei and National Yang-Ming University School of Medicine, Taiwan, Republic of China.

出版信息

Am J Gastroenterol. 1999 Apr;94(4):1006-11. doi: 10.1111/j.1572-0241.1999.01004.x.

Abstract

OBJECTIVE

Portal lymphoid aggregates/follicles (lymphoid A/F) is a characteristically histological finding in patients with chronic hepatitis C. We assessed the prevalence of lymphoid A/F in Chinese patients with chronic hepatitis C and evaluated the correlation of this phenomenon with clinical, biochemical, immunological, virological, and other histological features of these patients.

METHODS

Eighty-nine Chinese patients with chronic hepatitis C were enrolled and portal lymphoid A/F was evaluated in liver biopsy. Clinical, biochemical, immunological, histological, and virological data, including serum HCV RNA titer and HCV genotype and the response to interferon therapy, were compared between patients with and without portal lymphoid A/F.

RESULTS

Twenty-nine (33%) of 89 patients with chronic hepatitis C had portal lymphoid A/F. Patients with lymphoid A/F had a significantly higher frequency of HCV genotype 1b infection (p = 0.039) and had a significantly higher mean score of bile duct damage, periportal necroinflammation, and portal inflammation in liver histologies when compared with patients without lymphoid A/F. No significant difference in sex distribution, mean age, history of blood transfusion, serum liver biochemistry, presence of serum autoantibodies/cryoglobulinemia, serum viral titer, and response to interferon therapy was noted between the two groups. Multivariate logistic regression analysis showed HCV genotype 1b infection and periportal necroinflammation were significant independent predictors associated with portal lymphoid A/F.

CONCLUSIONS

The presence of portal lymphoid A/F in Chinese patients with chronic hepatitis C was significantly correlated with HCV genotype 1b infection and periportal necroinflammation.

摘要

目的

门静脉淋巴样聚集/滤泡(淋巴样A/F)是丙型肝炎患者典型的组织学表现。我们评估了中国丙型肝炎患者中淋巴样A/F的患病率,并评估了这一现象与这些患者的临床、生化、免疫、病毒学及其他组织学特征之间的相关性。

方法

纳入89例中国丙型肝炎患者,通过肝活检评估门静脉淋巴样A/F情况。比较有和没有门静脉淋巴样A/F的患者的临床、生化、免疫、组织学和病毒学数据,包括血清HCV RNA滴度、HCV基因型以及对干扰素治疗的反应。

结果

89例慢性丙型肝炎患者中有29例(33%)存在门静脉淋巴样A/F。与没有淋巴样A/F的患者相比,有淋巴样A/F的患者HCV 1b基因型感染频率显著更高(p = 0.039),并且在肝组织学中胆管损伤、汇管区坏死性炎症和门静脉炎症的平均评分显著更高。两组在性别分布、平均年龄、输血史、血清肝生化指标、血清自身抗体/冷球蛋白血症的存在情况、血清病毒滴度以及对干扰素治疗的反应方面均未发现显著差异。多因素logistic回归分析显示,HCV 1b基因型感染和汇管区坏死性炎症是与门静脉淋巴样A/F相关的显著独立预测因素。

结论

中国慢性丙型肝炎患者中门静脉淋巴样A/F的存在与HCV 1b基因型感染和汇管区坏死性炎症显著相关。

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