Song Alice Tung Wan, Mello Evandro Sobroza de, Alves Venâncio Avancini Ferreira, Cavalheiro Norma de Paula, Melo Carlos Eduardo, Bonazzi Patricia Rodrigues, Tengan Fatima Mitiko, Freire Maristela Pinheiro, Barone Antonio Alci, D'Albuquerque Luiz Augusto Carneiro, Abdala Edson
Divisão de Transplante de Fígado e Órgãos do Aparelho Digestivo, Universidade de São Paulo.
Departamento de Patologia, Universidade de São Paulo.
Mem Inst Oswaldo Cruz. 2015 Feb;110(1):56-64. doi: 10.1590/0074-02760140192. Epub 2015 Feb 13.
Histology is the gold standard for diagnosing acute rejection and hepatitis C recurrence after liver transplantation. However, differential diagnosis between the two can be difficult. We evaluated the role of C4d staining and quantification of hepatitis C virus (HCV) RNA levels in liver tissue. This was a retrospective study of 98 liver biopsy samples divided into four groups by histological diagnosis: acute rejection in patients undergoing liver transplant for hepatitis C (RejHCV+), HCV recurrence in patients undergoing liver transplant for hepatitis C (HCVTx+), acute rejection in patients undergoing liver transplant for reasons other than hepatitis C and chronic hepatitis C not transplanted (HCVTx-). All samples were submitted for immunohistochemical staining for C4d and HCV RNA quantification. Immunoexpression of C4d was observed in the portal vessels and was highest in the HCVTx- group. There was no difference in C4d expression between the RejHCV+ and HCVTx+ groups. However, tissue HCV RNA levels were higher in the HCVTx+ group samples than in the RejHCV+ group samples. Additionally, there was a significant correlation between tissue and serum levels of HCV RNA. The quantification of HCV RNA in liver tissue might prove to be an efficient diagnostic test for the recurrence of HCV infection.
组织学是诊断肝移植术后急性排斥反应和丙型肝炎复发的金标准。然而，两者之间的鉴别诊断可能存在困难。我们评估了C4d染色及肝组织中丙型肝炎病毒（HCV）RNA水平定量的作用。这是一项对98份肝活检样本的回顾性研究，根据组织学诊断将其分为四组：丙型肝炎患者肝移植术后急性排斥反应（RejHCV+）、丙型肝炎患者肝移植术后HCV复发（HCVTx+）、非丙型肝炎原因肝移植患者的急性排斥反应以及未进行移植的慢性丙型肝炎（HCVTx-）。所有样本均进行C4d免疫组化染色及HCV RNA定量检测。在门静脉中观察到C4d的免疫表达，且在HCVTx-组中最高。RejHCV+组和HCVTx+组之间C4d表达无差异。然而，HCVTx+组样本中的组织HCV RNA水平高于RejHCV+组样本。此外，组织和血清中的HCV RNA水平之间存在显著相关性。肝组织中HCV RNA的定量检测可能是诊断HCV感染复发的有效检测方法。
