Kage M, Fujisawa T, Shiraki K, Tanaka T, Fujisawa T, Kimura A, Shimamatsu K, Nakashima E, Kojiro M, Koike M, Tazawa Y, Abukawa D, Okaniwa M, Takita H, Matsui A, Hayashi T, Etou T, Terasawa S, Sugiyama K, Tajiri H, Yoden A, Kajiwara Y, Sata M, Uchimura Y
First Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan.
Hepatology. 1997 Sep;26(3):771-5. doi: 10.1002/hep.510260333.
Limited information is available regarding the histology of hepatitis C virus infection in children. The aim of this study was to determine the histological pattern of chronic hepatitis C (CHC) in children, and liver biopsy specimens from 109 pediatric patients with CHC were examined. Each biopsy specimen was evaluated based on a numerical scoring system for the stage of fibrosis (1-4), the grade of portal/periportal necroinflammation (0-4), the grade of lobular necroinflammation (0-4), and their sum (final grade). The histological lesions considered to be characteristic of chronic hepatitis were also evaluated. None of the children had liver cirrhosis, and 105 cases (97%) were stage 1 or 2. Only 4 children were stage 3. Two of these 4 cases showed hemosiderosis. A significant correlation was observed between the staging score and the final grade in the pediatric patients (r = .59; P < .0001). The histological characteristics of adult CHC, such as lymphoid aggregate, bile duct injury, and fatty changes, were also observed in the children. In conclusion, the majority of children with CHC presented with mild fibrosis, but a few showed CHC with lobular distortion and hemosiderosis. Frequent blood transfusion may aggravate hepatic lesions in pediatric CHC.
关于儿童丙型肝炎病毒感染的组织学情况，目前可获取的信息有限。本研究旨在确定儿童慢性丙型肝炎（CHC）的组织学模式，并对109例儿童CHC患者的肝活检标本进行了检查。每个活检标本根据纤维化阶段（1 - 4级）、门脉/门周坏死性炎症分级（0 - 4级）、小叶坏死性炎症分级（0 - 4级）及其总和（最终分级）的数字评分系统进行评估。还对被认为是慢性肝炎特征性的组织学病变进行了评估。所有儿童均无肝硬化，105例（97%）为1期或2期。只有4例儿童为3期。这4例中的2例显示有含铁血黄素沉着症。在儿童患者中，分期评分与最终分级之间存在显著相关性（r = 0.59；P < 0.0001）。在儿童中也观察到了成人CHC的组织学特征，如淋巴滤泡、胆管损伤和脂肪变性。总之，大多数儿童CHC表现为轻度纤维化，但少数儿童显示有小叶变形和含铁血黄素沉着症的CHC。频繁输血可能会加重儿童CHC的肝脏病变。
