Center for Anatomy and Functional Morphology, Mount Sinai School of Medicine, New York, New York, USA.
Anat Rec (Hoboken). 2012 Jan;295(1):40-50. doi: 10.1002/ar.21525. Epub 2011 Dec 5.
The incidence of hepatic steatosis, fibrosis, and cancer in the elderly population remains unknown. Human cadavers used in anatomy teaching, which come largely from older adults, may provide liver tissue for examining their pathologies. Livers were obtained from 68 cadavers (mean age 82.1 ± 10.4 years) with diverse causes of death in the Anatomy course at Mount Sinai School of Medicine. Paraffin sections were stained with hematoxylin and eosin and Sirius red and evaluated for steatosis, fibrosis, cancer, and lipofuscin. Tissue preservation was graded as good in 38.2% of the embalmed livers, fair in 36.7%, and poor in 25.0%. Steatosis was observed in 35.3% of the livers, central vein fibrosis in 49.2%, perisinusoidal fibrosis in 63.2%, portal tract (PT) fibrosis in 47.0%, septa formation in 44.1%, bridging fibrosis in 30.8%, and cirrhosis in 4.4%. One hepatocellular carcinoma (HCC) and six metastatic tumors were detected. Lobular inflammation occurred in 20.8% of the livers and PT inflammation in 38.8%. Nine livers showed minimal change. Lipofuscin was detected in 60.2% of the livers. Steatosis, fibrosis, and cancer are highly prevalent in elderly cadavers with diverse causes of death. The prevalence of steatosis and fibrosis is consistent with the data in patients with specific liver diseases. Steatosis alongside fibrosis can accelerate the progression of fibrosis to cirrhosis and ultimately HCC. Though not indicated as the primary cause of death, the liver injury may have compromised hepatic functions and enhanced disease susceptibility, thereby exacerbating the health conditions in this elderly population.
老年人的肝脂肪变性、纤维化和癌症发病率尚不清楚。解剖学教学中使用的人体尸体主要来自老年人，它们可能为检查其病理学提供肝脏组织。在西奈山医学院的解剖学课程中，我们从 68 具因各种原因死亡的尸体中获得了肝脏（平均年龄 82.1±10.4 岁）。石蜡切片用苏木精和伊红以及天狼猩红染色，评估脂肪变性、纤维化、癌症和脂褐素。组织保存情况评为良好的占 38.2%，一般的占 36.7%，差的占 25.0%。35.3%的肝脏存在脂肪变性，49.2%的肝脏中央静脉纤维化，63.2%的肝脏窦周纤维化，47.0%的肝脏门脉区纤维化，44.1%的肝脏间隔形成，30.8%的肝脏桥接纤维化，4.4%的肝脏肝硬化。发现 1 例肝细胞癌（HCC）和 6 例转移性肿瘤。20.8%的肝脏存在小叶炎症，38.8%的肝脏存在门脉区炎症。9 例肝脏显示最小的变化。60.2%的肝脏检测到脂褐素。具有不同死因的老年尸体中，脂肪变性、纤维化和癌症的发病率很高。脂肪变性和纤维化的患病率与特定肝脏疾病患者的数据一致。脂肪变性伴纤维化可加速纤维化向肝硬化的进展，最终导致 HCC。虽然未被列为主要死因，但肝损伤可能损害了肝脏功能并增强了疾病易感性，从而使老年人群的健康状况恶化。
