Department of Pathology, Faculty of Medicine, Health Science Centre, Kuwait University, P.O. Box. 24923, 13110 Safat, Kuwait.
Acta Histochem. 2009;111(6):520-30. doi: 10.1016/j.acthis.2008.04.008. Epub 2008 Oct 1.
The activation of hepatic stellate cells (HSCs) is a critical event in hepatic fibrosis. The objectives of this study were to find out if cluster of differentiation 38 (CD38) can be demonstrated immunohistochemically on HSCs in liver biopsies from patients with chronic liver disease and if CD38 immunopositive HSC count is correlated with METAVIR inflammatory and fibrosis scores. Immunohistochemical labelling for CD38 was performed on 100 liver biopsies from patients with chronic liver disease. The CD38 immunopositive HSCs were identified and counted. The CD38 immunopositive HSC count was found to be associated with both the METAVIR score and the fibrosis scores. The CD38 immunopositive HSC count was able to discriminate between no fibrosis and stages 2, 3 or 4 fibrosis, but could not discriminate between no fibrosis and stage 1 fibrosis. Using receiver operating characteristic (ROC) curves, a cut-off point of 10 HSCs per 10 high power field (hpf), or 25 per 100 hepatocytes, is 80% sensitive and 70% specific for predicting fibrosis. The specificity rose to 100% in patients with hepatitis C viral (HCV) infection. We conclude that CD38 positive HSCs can be demonstrated immunohistochemically and that the count is highly predictive of moderate to severe hepatic fibrosis.
肝星状细胞 (HSCs) 的激活是肝纤维化的关键事件。本研究的目的是确定在慢性肝病患者的肝活检中是否可以通过免疫组织化学方法检测到分化群 38 (CD38) 是否存在于 HSCs 上，以及 CD38 免疫阳性 HSC 计数是否与 METAVIR 炎症和纤维化评分相关。对 100 例慢性肝病患者的肝活检进行了 CD38 免疫组织化学标记。鉴定并计数 CD38 免疫阳性 HSCs。CD38 免疫阳性 HSC 计数与 METAVIR 评分和纤维化评分均相关。CD38 免疫阳性 HSC 计数能够区分无纤维化和 2、3 或 4 期纤维化，但不能区分无纤维化和 1 期纤维化。使用受试者工作特征 (ROC) 曲线，10 个高倍视野 (hpf) 或 100 个肝细胞中每 10 个 CD38 阳性 HSC 的切点为 80%敏感和 70%特异预测纤维化。在丙型肝炎病毒 (HCV) 感染患者中，特异性上升至 100%。我们得出结论，CD38 阳性 HSCs 可以通过免疫组织化学方法证明，其计数高度预测中度至重度肝纤维化。
