Hamada M, Kihira T, Takase K, Nakano T, Tameda Y, Kosaka Y
First Department of Internal Medicine, Mie University, School of Medicine, Japan.
J Gastroenterol. 1995 Jun;30(3):372-8. doi: 10.1007/BF02347514.
To evaluate the usefulness of proliferating cell nuclear antigen (PCNA) immunostaining in the assessment of the efficacy of interferon (IFN) therapy in chronic hepatitis C, we investigated the proliferative activity of hepatocytes in 67 patients with chronic hepatitis C, using this immunostaining method. The percentage of PCNA-positive hepatocytes was 2.4% in patients with chronic persistent hepatitis, 2.5% in those with chronic aggressive hepatitis 2A, and 3.9% in those with chronic aggressive hepatitis 2B. The PCNA count increased with the progression of the liver disease. Patients were classified as complete, partial, and non-responders to IFN; the percentage of PCNA-positive hepatocytes before IFN therapy was 1.6% in the complete responders, 3.9% in the partial responders, and 4.9% in the non-responders. There was a significant negative correlation between the percentage of PCNA-positive hepatocytes and the response to IFN treatment. Thirty-two of 53 cases (60.4%) in which the PCNA labeling index (LI) was less than 5.0 were complete responders compared with 13 of 14 cases (92.9%) in which the PCNA LI was higher than 5.0, representing partial responders or non-responders (P < 0.001). Most complete responders had a low PCNA LI, irrespective of HCV genotype. Our findings indicate that PCNA immunostaining is a simple and reliable index of cell proliferation in liver regeneration, and may be a useful predictor of the response to IFN treatment in chronic hepatitis C.
为评估增殖细胞核抗原（PCNA）免疫染色在慢性丙型肝炎干扰素（IFN）治疗疗效评估中的作用，我们采用这种免疫染色方法，对67例慢性丙型肝炎患者的肝细胞增殖活性进行了研究。慢性持续性肝炎患者中PCNA阳性肝细胞的百分比为2.4%，慢性活动性肝炎2A患者中为2.5%，慢性活动性肝炎2B患者中为3.9%。PCNA计数随肝病进展而增加。患者被分为对IFN完全应答、部分应答和无应答者；IFN治疗前，完全应答者中PCNA阳性肝细胞的百分比为1.6%，部分应答者中为3.9%，无应答者中为4.9%。PCNA阳性肝细胞的百分比与IFN治疗反应之间存在显著负相关。53例PCNA标记指数（LI）小于5.0的病例中有32例（60.4%）为完全应答者，而14例PCNA LI高于5.0的病例中有13例（92.9%）为部分应答者或无应答者（P<0.001）。大多数完全应答者的PCNA LI较低，与HCV基因型无关。我们的研究结果表明，PCNA免疫染色是肝再生中细胞增殖的一个简单可靠指标，可能是慢性丙型肝炎IFN治疗反应的一个有用预测指标。
