Lee Hwajeong, Ainechi Sanaz, Dresser Karen, Kurian Elizabeth M
Anatomic Pathology, Albany Medical College, 47 New Scotland Avenue, MC81, Albany, NY 12208, USA ; Anatomic Pathology, University of Massachusetts, 1 Innovation Drive, Biotech 3, Worcester, MA 01605, USA.
Anatomic Pathology, Albany Medical College, 47 New Scotland Avenue, MC81, Albany, NY 12208, USA.
Int J Hepatol. 2014;2014:329297. doi: 10.1155/2014/329297. Epub 2014 Nov 30.
Concomitant steatosis in chronic hepatitis C is associated with fibrosis and unfavorable treatment outcome. Central zone injury in nonalcoholic steatohepatitis (NASH) manifests as central portalization, with centrizonal microvessels and ductular reaction. We investigated whether central portalization in steatotic HCV biopsies would identify patients with metabolic risk factors for NASH. Liver biopsies with chronic hepatitis C and >10% steatosis (n = 65) were evaluated for the degree of steatosis, zonation of steatosis, fibrosis, and nonalcoholic fatty liver disease (NAFLD) activity score. The presence of centrizonal microvessels, sinusoidal capillarization, ductular reaction, and CK7 positive intermediate-phenotype hepatocytes were evaluated by CD34 and CK7 immunostain. The degree of steatosis and fibrosis showed a positive correlation. Additional positive correlations were noted between centrizonal angiogenesis and NAFLD activity score and central portalization and fibrosis. However, neither central portalization nor zonation of steatosis identified patients with metabolic risk factors for NASH. Therefore, central portalization cannot be used as a surrogate marker to identify patients with metabolic risk factors for NASH in steatotic HCV biopsies. The mechanism of centrizonal injury in steatotic HCV hepatitis is not solely attributable to the metabolic risk factors for NASH.
慢性丙型肝炎中的合并脂肪变性与纤维化及不良治疗结局相关。非酒精性脂肪性肝炎（NASH）中的中央区损伤表现为中央门静脉化，伴有中央区微血管和小胆管反应。我们研究了脂肪变性的丙型肝炎活检中的中央门静脉化是否能识别出具有NASH代谢危险因素的患者。对65例慢性丙型肝炎且脂肪变性>10%的肝活检组织进行脂肪变性程度、脂肪变性分区、纤维化及非酒精性脂肪性肝病（NAFLD）活动评分评估。通过CD34和CK7免疫染色评估中央区微血管、窦状隙毛细血管化、小胆管反应及CK7阳性中间型肝细胞的存在情况。脂肪变性程度与纤维化呈正相关。中央区血管生成与NAFLD活动评分以及中央门静脉化与纤维化之间也存在额外的正相关。然而，中央门静脉化和脂肪变性分区均未识别出具有NASH代谢危险因素的患者。因此，在脂肪变性的丙型肝炎活检中，中央门静脉化不能用作识别具有NASH代谢危险因素患者的替代标志物。脂肪变性的丙型肝炎肝炎中中央区损伤的机制并非完全归因于NASH的代谢危险因素。
