Lee R G, Epstein O, Jauregui H, Sherlock S, Scheuer P J
Gastroenterology. 1981 Dec;81(6):983-6.
To evaluate the significance of granulomas in primary biliary cirrhosis, 295 liver biopsy specimens from 100 patients with primary biliary cirrhosis were reviewed. Granulomas were found in specimens from 54 patients and were less frequent as histologic stage increased. They often persisted in multiple specimens from individual patients. Granulomas did not correlate with clinical presentation or biochemical values, but were associated with better survival since of the 18 patients who died, only 2 showed granulomas on biopsy. To test this finding in patients at a uniform stage of progression, patients with late primary biliary cirrhosis were evaluated separately. Patients with and without granulomas were closely matched in clinical, laboratory, and histologic features. Although 23 of these 57 patients showed granulomas, they were present in only 1 of 14 patients who died. Thus, the presence of granulomas in primary biliary cirrhosis seems to be of prognostic significance, independent of previously reported prognostic indicators.
为评估肉芽肿在原发性胆汁性肝硬化中的意义，对100例原发性胆汁性肝硬化患者的295份肝活检标本进行了回顾性分析。54例患者的标本中发现了肉芽肿，且随着组织学分期增加，肉芽肿的发生率降低。它们常持续存在于个体患者的多个标本中。肉芽肿与临床表现或生化指标无关，但与较好的生存率相关，因为在18例死亡患者中，只有2例活检显示有肉芽肿。为在疾病进展统一阶段的患者中验证这一发现，对晚期原发性胆汁性肝硬化患者进行了单独评估。有肉芽肿和无肉芽肿的患者在临床、实验室和组织学特征方面进行了密切匹配。尽管这57例患者中有23例显示有肉芽肿，但在14例死亡患者中只有1例存在肉芽肿。因此，原发性胆汁性肝硬化中肉芽肿的存在似乎具有预后意义，独立于先前报道的预后指标。
