Comănescu V, Ardeleanu C, Zaharia B, Florescu M, Simionescu C, Comănescu C
County Clinical Hospital, Craiova.
Rom J Morphol Embryol. 1997 Jul-Dec;43(3-4):169-72.
Complete diagnosis of chronic hepatitis relies on exploring the liver by bipsic punction, performing the classic histopathologic and immunohistochemic exams. We worked out viral antigens hepatocytes by using avidin-biotin-peroxidase complex technique as following: Ag HBs placed in cytoplasm or at the level of the cell membrane. Ag HBc preferably placed in nucleus and, a small part of it, in cytoplasm. Ag HD present especially in nucleus. A correlation between tissular antigen expression and hepatic histopathologic aspect was established. Two main types of viral expression were remarked: a regressive type reflected by cytoplasmatic Ag HBs in the absence of generalised nuclear Ag HBc--situations linked to persistent chronic hepatitis: an aggressive type characterised by the presence of the focal nuclear Ag HBc, cytoplasmatic Ag HBc or antigen HD--situations linked to active chronic hepatitis with various degrees of severity.
慢性肝炎的完整诊断依赖于通过肝穿刺活检来探查肝脏，并进行经典的组织病理学和免疫组织化学检查。我们采用抗生物素蛋白-生物素-过氧化物酶复合物技术检测肝细胞中的病毒抗原，具体如下：乙肝表面抗原（Ag HBs）位于细胞质或细胞膜水平。乙肝核心抗原（Ag HBc）最好位于细胞核中，一小部分位于细胞质中。丁肝抗原（Ag HD）尤其存在于细胞核中。建立了组织抗原表达与肝脏组织病理学表现之间的相关性。观察到两种主要的病毒表达类型：一种是退行性类型，表现为细胞质中存在乙肝表面抗原而无普遍的细胞核内乙肝核心抗原，这种情况与持续性慢性肝炎相关；另一种是侵袭性类型，其特征是存在局灶性细胞核内乙肝核心抗原、细胞质内乙肝核心抗原或丁肝抗原，这种情况与不同严重程度的活动性慢性肝炎相关。
