Di Vinicius Igor, Baptista Ana Paula, Barbosa Aryon A Júnior, Andrade Zilton A
Laboratory of Experimental Pathology, Gonçalo Moniz Research Center (Fiocruz), Rua Valdemar Falcão 121, 40295-001 Salvador, BA, Brazil.
Pathol Res Pract. 2005;201(6):449-56. doi: 10.1016/j.prp.2005.05.009.
Regression of hepatic cirrhosis is a controversial issue. Recently, a list of histopathological features, observed in human material, was suggested as a hallmark of cirrhosis in the process of regression. An investigation for the presence of these morphologic features was performed at monthly intervals in rats with proved carbon tetrachloride (CCl4)-induced cirrhosis over a period of 9 months following discontinuation of treatment, using sequential liver biopsies. Within the first 4 months, features of the "hepatic repair complex" were identified, together with the enlargement of the hepatic nodules and thinning of the fibrous septa. Subsequent to the 4 months, the histological picture, composed of large and inconspicuous nodules and delimited by thin and frequently incomplete fibrous septa "incomplete septal cirrhosis", appeared to be stabilized. These fibrous septa, when injected with India ink from the portal trunk, presented blood vessels that were seen to drain directly into the sinusoids. These findings suggested that when the cause of cirrhosis is removed, the liver may adapt itself to a new and permanent structure, probably compatible with normal or near-normal function, which may render hepatic cirrhosis clinically, although not morphologically, reversible.
肝硬化的消退是一个有争议的问题。最近,在人体材料中观察到的一系列组织病理学特征被认为是肝硬化消退过程的标志。在停止治疗后的9个月内,对经证实由四氯化碳(CCl4)诱导肝硬化的大鼠,每月进行一次序贯肝活检,以调查这些形态学特征的存在情况。在最初的4个月内,识别出了“肝修复复合体”的特征,同时肝结节增大,纤维间隔变薄。4个月后,由大的且不明显的结节组成、由薄且常不完整的纤维间隔界定的组织学图像(“不完全间隔性肝硬化”)似乎稳定下来。当从门静脉主干注入印度墨汁时,这些纤维间隔呈现出直接引流至窦状隙的血管。这些发现表明,当肝硬化的病因被去除时,肝脏可能会适应一种新的永久性结构,这种结构可能与正常或接近正常的功能相适应,这可能使肝硬化在临床上(尽管不是形态学上)可逆。