Lang Z, Li D, Jin R
Beijing Youan Hospital.
Zhonghua Nei Ke Za Zhi. 1995 Nov;34(11):731-4.
Liver biopsy and autopsy specimens of 153 cases, including 39 cases of acute severe hepatitis (ASH), 21 cases of subacute severe hepatitis (SSH), 11 cases of chronic severe hepatitis (CSH), 22 cases of active cirrhosis (AC), 20 cases of acute mild (AMH), chronic persistent (CPH) and active hepatitis (CAH), respectively, were immunohistochemically stained for proliferating cell nuclear antigen (PCNA) to compare the proliferative activity of hepatocytes by using labelling index (LI). LI is higher in CAH, SSH, and AMH than in AC and CSH (P < 0.01). In the latter, LI was completely negative in most of the specimens (25/33, 75.8%) and few scattered hepatocytes positive for PCNA were found in the remaining 8 cases (8/33, 24.2%) in the area next to the fibrotic septum and varied greatly in different pseudolobules. The results showed that the proliferative activity was very low in the AC and CSH. In some cases of ASH, the residual hepatocytes still kept prominent proliferating ability; it meant that the survived percentage would have been increased with regeneration of hepatocytes if those patients had not died early. In ASH and SSH, LI was significantly higher in patients who survived than in those who died (P < 0.01). The detection of PCNA in liver tissue with severe viral hepatitis is useful for prognostic evaluation.
对153例肝脏活检和尸检标本进行免疫组织化学染色，检测增殖细胞核抗原（PCNA），以标记指数（LI）比较肝细胞的增殖活性。其中急性重型肝炎（ASH）39例，亚急性重型肝炎（SSH）21例，慢性重型肝炎（CSH）11例，活动性肝硬化（AC）22例，急性轻型肝炎（AMH）、慢性持续性肝炎（CPH）和活动性肝炎（CAH）各20例。CAH、SSH和AMH的LI高于AC和CSH（P<0.01）。在AC和CSH中，大多数标本（25/33，75.8%）的LI完全阴性，其余8例（8/33，24.2%）在纤维化间隔旁区域可见少量散在的PCNA阳性肝细胞，不同假小叶中的阳性细胞数量差异很大。结果显示，AC和CSH的增殖活性很低。在部分ASH病例中，残留肝细胞仍保持较强的增殖能力；这意味着，如果这些患者没有早期死亡，肝细胞再生可能会提高其存活率。在ASH和SSH中，存活患者的LI显著高于死亡患者（P<0.01）。检测重症病毒性肝炎肝组织中的PCNA有助于预后评估。
