Han Nam Ik, Lee Young Sok, Choi Hwang, Choi Jong Young, Yun Seung Kyu, Cho Se Hyun, Han Jun Youl, Yang Jin Mo, Ahn Byung Min, Choi Sang Wook, Lee Chang Don, Cha Sang Bok, Sun Hee Sik, Park Doo Ho
Department of Internal Medicine, Holy Family Hospital, Catholic University of Korea College of Medicine, 2 Sosa-dong, Wonmi-gu, Pucheon-City 420-717, Kyunggi-do, Korea.
Korean J Intern Med. 2002 Jun;17(2):100-6. doi: 10.3904/kjim.2002.17.2.100.
One of the major morphologic characteristics of hepatitis B is a hepatocellular regeneration which is induced by massive hepatocyte necrosis and associated with proliferative activity of hepatocytes. The purpose of this study is to document the proliferative activity of hepatocytes in various types of hepatitis B by immunohistochemical staining for proliferative cell nuclear antigen-labelling index (PCNA-LI) and electron microscopy.
We studied 83 patients with hepatitis B: 11 cases of acute viral hepatitis, 24 cases of mild chronic hepatitis, 34 cases of severe chronic hepatitis with early cirrhosis and 14 cases of severe chronic hepatitis. The PCNA was tested by immunohistochemical staining using anti-PCNA antibody. Furthermore we evaluated the ultrastructure of acinus-forming hepatocytes (AFH) by electron microscopy.
The expression rate and labelling index of PCNA were 27.3% and 5.3 +/- 0.9% in acute viral hepatitis, 62.5% and 22.9 +/- 31.7% in mild chronic hepatitis, and then 47.1% and 14.1 +/- 24.2% in severe chronic hepatitis with early cirrhosis, respectively (Figure 1). By contrast, no detectable PCNA expression was noted in AFH. Electron microscopic findings showed that hepatocytes forming a rosette underwent marked degenerative changes with sinusoidal capillarization and increased fine strands of collagen fiber in portal area.
The proliferative activity of hepatitis B was significantly decreased in severe chronic hepatitis containing AFH. This result suggested that differences in proliferative activity was associated with hepatic cell necrosis and AFH.
乙型肝炎的主要形态学特征之一是肝细胞再生，它由大量肝细胞坏死诱导，并与肝细胞的增殖活性相关。本研究的目的是通过对增殖细胞核抗原标记指数（PCNA-LI）进行免疫组化染色和电子显微镜检查，记录不同类型乙型肝炎中肝细胞的增殖活性。
我们研究了83例乙型肝炎患者：11例急性病毒性肝炎，24例轻度慢性肝炎，34例伴有早期肝硬化的重度慢性肝炎和14例重度慢性肝炎。使用抗PCNA抗体通过免疫组化染色检测PCNA。此外，我们通过电子显微镜评估了形成腺泡的肝细胞（AFH）的超微结构。
急性病毒性肝炎中PCNA的表达率和标记指数分别为27.3%和5.3±0.9%，轻度慢性肝炎中为62.5%和22.9±3.17%，在伴有早期肝硬化的重度慢性肝炎中分别为47.1%和14.1±2.42%（图1）。相比之下，在AFH中未检测到PCNA表达。电子显微镜检查结果显示，形成玫瑰花结的肝细胞发生明显退行性改变，伴有血窦毛细血管化和门管区胶原纤维细束增加。
在含有AFH的重度慢性肝炎中，乙型肝炎的增殖活性显著降低。这一结果表明，增殖活性的差异与肝细胞坏死和AFH有关。
