Ben Rejeb A, Khediri F, Ebdelli N, Bouali R, Ben Ahmed F
Service d'Anatomie et de Cytologie pathologique, Hôpital militaire de Tunis, Montfleury, Tunisie.
Ann Gastroenterol Hepatol (Paris). 1994 Sep;30(4):157-62.
The authors report a prospective study of 34 chronic HBs Ag carriers detected among a cohort of 9029 blood donors. Liver biopsy performed in all cases revealed a normal liver in 5 cases (14.7%), non-specific lesions in the form of fatty infiltration or mild portal inflammation in 3 cases (8.8%), chronic persistent hepatitis (CPH) in 21 cases (61.7%) (mild in 19 and moderate in 2) and chronic active hepatitis (CAH) in 5 cases (14.6%) (mild in 1 and moderate in 4). Liver function tests were abnormal in 28.8% of patients with CPH and 20% of those with CAH. Histologic activity index was calculated and was more than 6 in 40% of CAH and 6 or less in CPH and non-specific lesions. Immunohistochemical study revealed cytoplasmic labelling for HBs Ag in 82.4 per cent of cases and nuclear labelling for HBc Ag in 11.4% of cases with a heterogeneous and non-regular pattern affecting all or part of the cytoplasm, single or clusters of hepatocytes or even sheets of hepatocytes.
作者报告了一项对9029名献血者队列中检测出的34例慢性乙肝表面抗原携带者的前瞻性研究。所有病例均进行了肝活检,结果显示5例(14.7%)肝脏正常,3例(8.8%)表现为脂肪浸润或轻度门脉炎症形式的非特异性病变,21例(61.7%)为慢性持续性肝炎(CPH)(19例轻度,2例中度),5例(14.6%)为慢性活动性肝炎(CAH)(1例轻度,4例中度)。CPH患者中28.8%肝功能检查异常,CAH患者中20%肝功能检查异常。计算了组织学活动指数,40%的CAH患者该指数大于6,CPH和非特异性病变患者该指数为6或更低。免疫组织化学研究显示,82.4%的病例中乙肝表面抗原呈细胞质标记,11.4%的病例中乙肝核心抗原呈细胞核标记,标记模式不均匀且不规则,影响全部或部分细胞质、单个或成群的肝细胞甚至成片的肝细胞。