摘要
目的 研究Ⅳ—胶原(Ⅳ—Co)在慢性乙型肝炎(CHB)肝窦壁中的表达及其与病理分型、肝血管病变的关系。方法 对CHB—轻型、中型、重型及肝硬变(LC)患者各30例及5例大致正常肝组织通过Ⅳ—Co免疫组织化学(免疫组化)染色,观察Ⅳ—Co在肝窦壁中的表达情况,及与肝组织中的血管病变的关系。结果 在正常肝组织中,Ⅳ—Co在门管区的血管壁、中央静脉、胆管壁及部分肝窦壁中有弱阳性信号,在肝窦壁呈淡黄色纤细的继续弱阳性表达;在CHB肝组织中,随着肝脏病变的加重(轻～重型及LC),其肝血管病变加重,Ⅳ—Co表达范围增大,表达程度增加。至CHB—重型及LC,其肝血管病变皆为3级,常见严重的血管扭曲、扩张、阻塞及增生,伴有肝窦闭锁、扩张及阻塞,肝窦毛细血管化显著,Ⅳ—Co强阳性弥漫性表达于扩张肝窦壁,强阳性表达占多数(93.3％),LC假小叶内肝窦壁Ⅳ—Co皆呈弥漫性强阳性表达(10％),与CHB—轻、中型相比有极显著性差异(P<0.01)、结论 Ⅳ—Co在CHB肝组织中的表达程度及分布范围与其肝病变及血管病变关系密切。
Objective To study the relationship between the expression of Ⅳ-collage( Ⅳ-co)on hepatic sinusoidal walls of chronic hepatitis B (CHB) with different pathological type and hepatic vascular diseases. Methods Immunohistochemical staining with Ⅳ -co was performed on 30 cases of CHB in mild,middle and severe stage respectively and 5 cases of normal liver tissues as control. The expression of Ⅳ -co on hepatic sinusoidal walls and the hepatic vascular diseases in the liver tissues were observed. Results In the normal liver tissue Ⅳ -co expression showed on the vascular walls of portal area,central veins,bile duct walls and part of hepatic sinusoidal walls. But the staining was weak and slightly positive expression seen on hepatic sinusoidal walls. In CHB with aggrasive vascular diseases the expression range of Ⅳ -co enlarged and the expression degree increased accompaning with the severity of liver diseases. In severe CHB and LC the vascular diseases were all classified in the third degree. Severe vascular twisting,dilatation .obstruction and proliferation could be seen accompaning with sinusoidal atresia .dilatation,obstruction and the sinusoidal capillarization. The Ⅳ -co diffusely expressed on the dilated sinusoidal walls was 93. 3%. In cases of LC the rate of Ⅳ-co strongly diffusely positive expression on the sinusoidal walls in pseudolobules was 100%. There was significant difference comparing with that of CHB of mild and middle stage (P<0. 01). Conclusion The degree of expression and the distribution of Ⅳ -co in HB are closely related with the severity of liver diseases and vascular diseases.
