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[肝活检中丙型肝炎RNA的检测与分型及其与组织病理学的比较]

[Detection and typing of hepatitis C RNA in liver biopsies in comparison with histopathology].

作者信息

Cathomas G, McGandy C E, Terracciano L M, Gudat F, Bianchi L

机构信息

Institut für Pathologie, Kantonsspital Basel, Universität Basel.

出版信息

Verh Dtsch Ges Pathol. 1995;79:254-7.

PMID:8600689
Abstract

Total RNA of 55 frozen liver biopsies were extracted and tested for the presence of HCV RNA and the genotype by RT-PCR using primers of the 5' non-coding region and a type specific primer set for HCV genotyping. In paralell, the activity of chronic hepatitis, the stage of fibrosis as well as chracteristic features of chronic hepatitis C were evaluated by conventional histology. HCV RNA was detected in 49 (89.1%) of 55 liver specimen by either primer set and genotyping was successful in 42 (76.4%) of liver biopsies. The samples were divided in 3 groups: Group A consisted of specimens infected with genotypes 1a, 2a and 2b (n = 13), Group B contained biopsies infected with genotype 1b (n = 24) and Group C were biopsies with two or no detectable genotype. The histology showed a significant higher degree of fibrosis/cirrhosis in Group B (genotype 1b) compared to Group A (11/24 vs. 0/13, p = 0.011). In addition, an advanced fibrosis/cirrhosis was found more often in Group C than B, however, this difference was not significant (5/15 vs. 0/13, p = 0.072). No difference was seen between the three groups with respect to the activity of chronic hepatitis, presence of lymphoid follicles, bile duct lesions or steatosis. We conclude that HCV RNA can readily be detected and typed in frozen liver tissue. Patients infected with HCV genotype 1b have an increased risk developing liver fibrosis and cirrhosis.

摘要

提取55份冷冻肝活检组织的总RNA,使用5'非编码区引物和一组用于丙型肝炎病毒(HCV)基因分型的型特异性引物,通过逆转录聚合酶链反应(RT-PCR)检测HCV RNA的存在及基因型。同时,采用传统组织学方法评估慢性肝炎的活动度、纤维化阶段以及丙型肝炎的特征。使用任何一组引物,在55份肝标本中有49份(89.1%)检测到HCV RNA,42份肝活检组织(76.4%)基因分型成功。样本分为3组:A组由感染1a、2a和2b基因型的标本组成(n = 13),B组包含感染1b基因型的活检组织(n = 24),C组为未检测到基因型或检测到两种基因型的活检组织。组织学显示,与A组相比,B组(1b基因型)的纤维化/肝硬化程度显著更高(11/24比0/13,p = 0.011)。此外,C组比B组更常发现进展期纤维化/肝硬化,然而,这种差异不显著(5/15比0/13,p = 0.072)。三组在慢性肝炎活动度、淋巴滤泡存在情况、胆管病变或脂肪变性方面未见差异。我们得出结论,在冷冻肝组织中可轻松检测到HCV RNA并进行基因分型。感染HCV 1b基因型的患者发生肝纤维化和肝硬化的风险增加。

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