Gastrointestinal and Liver Pathology Research Laboratory, Department of Pathology, Karolinska Institute and University Hospital, Stockholm, Sweden.
In Vivo. 2012 Mar-Apr;26(2):319-21.
Autoimmune hepatitis (AIH) is a non-resolving inflammatory liver disease. Inflammation showing plasma cells under hematoxylin-eosin (H&E) stain is typical of AIH. In many cases, however, only lymphocytes and occasional granulocytes are found. It was recently noticed that the antibody to multiple myeloma oncogene 1/IRF4 (MUM1), stained plasma cells and their precursors.
Liver biopsies from 11 patients were stained with H&E and with anti-MUM1. Clinically, four patients were suspicious of AIH, four had viral hepatitis C, two nonalcoholic steatohepatitis (NASH) and one, fatty liver. Counting was performed in three high-power fields.
In patients having clinical suspicion of AIH, H&E revealed plasma cells in only one of the four cases. On the other hand, MUM1 immunostain revealed such cells in all four cases, MUM1-expressing cells were found in the portal triads, in the zone corresponding to interface inflammation and in the parenchyma surrounding the interface hepatitis. MUM 1-expressing cells ranged from 26 to 44 in AIH, from 2 to 15 in viral hepatitis C, from 1 to 3 in NASH, and from 0 to 2 in the case with fatty liver (AIH vs. viral hepatitis C/NAS/fatty liver, p<0.05).
These preliminary results suggest that MUM1 immunostain may be of help in endorsing a presumptive clinical diagnosis of AIH and may add valuable information in the differential diagnosis between AIH and the other liver diseases examined here. This appears to be the first report in which MUM1 immunostain has been applied to assess the presence of plasma cell precursors in AIH.
自身免疫性肝炎（AIH）是一种非自限性炎症性肝病。苏木精-伊红（H&E）染色下的浆细胞炎症是 AIH 的典型表现。然而，在许多情况下，仅发现淋巴细胞和偶尔的粒细胞。最近有人注意到多发性骨髓瘤致癌基因 1/IRF4（MUM1）抗体可染色浆细胞及其前体细胞。
对 11 名患者的肝活检进行了 H&E 和抗 MUM1 染色。临床上，4 名患者疑似 AIH，4 名患者患有丙型病毒性肝炎，2 名患者患有非酒精性脂肪性肝炎（NASH），1 名患者患有脂肪肝。在三个高倍视野中进行计数。
在具有 AIH 临床怀疑的患者中，仅在 4 例中的 1 例中发现 H&E 浆细胞。另一方面，MUM1 免疫染色在所有 4 例中均显示出这些细胞，MUM1 表达细胞存在于门三联体、界面炎症对应的区域和界面肝炎周围的实质中。MUM1 表达细胞在 AIH 中为 26-44 个，在丙型病毒性肝炎中为 2-15 个，在 NASH 中为 1-3 个，在脂肪肝中为 0-2 个（AIH 与丙型病毒性肝炎/NASH/脂肪肝相比，p<0.05）。
这些初步结果表明，MUM1 免疫染色可能有助于支持 AIH 的临床诊断，并在 AIH 与本文研究的其他肝病的鉴别诊断中提供有价值的信息。这似乎是首次应用 MUM1 免疫染色来评估 AIH 中浆细胞前体存在的报告。
