Zhang Rui, Lin Jiansong, Qu Lijuan, Zheng Feng, Zheng Zhiyong
Department of Pathology, Dongfang Hospital, Fujian Medical University, Fuzhou, China; Department of Pathology, The Second Hospital of Xiamen, Xiamen, China.
Department of Pathology, Dongfang Hospital, Fujian Medical University, Fuzhou, China.
Ann Diagn Pathol. 2014 Apr;18(2):104-8. doi: 10.1016/j.anndiagpath.2014.01.001. Epub 2014 Jan 6.
C3d deposition in peritubular capillaries has been demonstrated to indicate antibody-mediated alloresponse during renal transplantation. C3d deposition in renal arterioles in IgA nephropathy (IgAN), however, is poorly documented. Especially, its significance to the pathology of primary glomerulonephritis remains unclear. This retrospective study included 340 patients with IgAN who underwent renal biopsy at our center. C3d strongly positive deposition in arterioles was observed in 123 (36.2%) of the 340 cases, and weakly positive deposition of C3d was observed in 217 cases (63.8%). In the weakly positive group, C3d mainly deposited in the intima of arterioles. In the strongly positive group, C3d deposited in the intima and the media of arterioles, presenting as the medial thickening and sclerosis of varying severities. The prognosis was worse in the C3d strongly positive group than in the weakly positive group during a 2-year follow-up (P = .027). The predictive value of C3d deposition in the media of arterioles in patients with IgAN may be a useful marker for arteriolosclerosis indicating unfavorable clinical outcomes.
肾移植过程中，肾小管周围毛细血管中的C3d沉积已被证实可表明抗体介导的同种异体反应。然而，IgA肾病（IgAN）肾小动脉中的C3d沉积记录较少。特别是，其对原发性肾小球肾炎病理的意义仍不清楚。这项回顾性研究纳入了在我们中心接受肾活检的340例IgAN患者。340例病例中有123例（36.2%）观察到小动脉中C3d强阳性沉积，217例（63.8%）观察到C3d弱阳性沉积。在弱阳性组中，C3d主要沉积在小动脉内膜。在强阳性组中，C3d沉积在小动脉内膜和中膜，表现为不同程度的中膜增厚和硬化。在2年随访期间，C3d强阳性组的预后比弱阳性组差（P = 0.027）。IgAN患者小动脉中膜C3d沉积的预测价值可能是提示不良临床结局的小动脉硬化的有用标志物。
