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慢性丙型肝炎肝纤维化过程——组织学与免疫组织化学研究

The process of liver fibrosis in chronic hepatitis C - histological and immunohistochemical study.

作者信息

Popescu Nicoleta Laura, Predescu Octavian Ion, Badea Oana, Pirici Ionica, Pantiş Carmen, Busuioc Cristina Jana, Cotoi Bogdan Virgil, Mogoantă Laurenţiu

机构信息

Research Center for Microscopic Morphology and Immunology, University of Medicine and Pharmacy of Craiova, Romania;

出版信息

Rom J Morphol Embryol. 2018;59(4):1121-1126.

Abstract

Liver fibrosis is one of the most serious histopathological (HP) lesions that, together with the inflammatory process and the hepatocyte lesions, determine the change of the liver architecture, having as a clinical result the onset of liver failure phenomena. Hepatitis C virus represents one of the most frequent conditions leading to the onset of liver fibrosis and favors the progression of the disease towards hepatocellular carcinoma. We evaluated the HP and immunohistochemical (IHC) aspects on fragments of liver biopsies taken from 104 patients diagnosed with chronic hepatitis C and altered capacity of work. In our study, we observed a growth of the portal (Kiernan) spaces by the presence of a chronic inflammatory infiltrate, the presence of collagen fibers and conjunctive matrix. The density and dimensions of collagen fibers were correlated with the severity of the liver disease, in the severe forms being highlighted porto-portal and porto-central fibrous bridges. The IHC examinations highlighted the change of the phenotype of perisinusoidal dendritic cells, the growth of the myofibroblast cells in the portal spaces, the growth of the macrophage number in the inflammatory infiltrate and of the Kupffer cells in the liver parenchyma.

摘要

肝纤维化是最严重的组织病理学(HP)病变之一,它与炎症过程和肝细胞病变共同决定肝脏结构的改变,其临床后果是出现肝衰竭现象。丙型肝炎病毒是导致肝纤维化发生的最常见病因之一,并促使疾病向肝细胞癌发展。我们评估了取自104例诊断为慢性丙型肝炎且工作能力受损患者的肝活检组织切片的HP和免疫组织化学(IHC)特征。在我们的研究中,我们观察到由于慢性炎症浸润、胶原纤维和结缔组织基质的存在,门管(基尔南)间隙增大。胶原纤维的密度和尺寸与肝脏疾病的严重程度相关,在严重形式中可见门静脉-门静脉和门静脉-中央纤维桥。IHC检查突出显示了肝血窦周树突状细胞表型的改变、门管间隙中肌成纤维细胞的增多、炎症浸润中巨噬细胞数量的增多以及肝实质中库普弗细胞的增多。

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