穿孔素及颗粒酶B在肝移植排斥反应中的表达及意义

Perforin aud granzyme B expression in liver allograft rejection

目的 检测穿孔素和颗粒酶B在肝移植术后排斥反应中的表达情况,以评价其作为肝移植术后排斥反应的早期诊断指标价值。方法 收集35个肝移植术后肝穿刺标本,应用免疫组织化学方法检测穿孔素和颗粒酶B表达,并与病理组织学结果相比较,研究其表达与急性排斥反应的关系。结果 在35个标本中,19个经病理组织学诊断为排斥反应,其中急性排斤17例次,慢性排斥2例次。其中穿孔素和颗粒酶B在排斥反应者中的表达阳性率分别为100％(19/19)和94.7％(18/19)。而在未发生排斥反应者中,其表达阳性率分别为25.0％(4/16)和12.5％(2/16)。穿孔素及颗粒酶B多呈同步表达,仅3个标本为仅有穿孔素表达而无颗粒酶B表达,未观察到仅有颗粒酶B表达而无穿孔素表达。穿孔素和颗粒酶B的阳性表达与移植肝急性排斥反应的发生密切相关。结论 穿孔素和颗粒酶B参与了肝移植后排斥反应的发生,其表达可作为术后急性排斥反应的辅助诊断指标。

Objective To investigate the expression of perforin and granzyme B in rejection response following liver transplantation, and evaluate their roles to be used as predictive markers of rejection. Methods The expression of perforin and granzyme B in liver biopsies obtained from liver allograft recipients was determined by immunohistochemistry. Biopsies were classified into two groups-no evidence of rejection and rejection-according to Histopathologic criteria. The relationship between the perforin/granzume B expression and acute rejection was analyzed. Results From 19 patients, thirty-five liver biopsies were obtained after liver transplantation. Among them, nineteen samples were diagnosed as rejection response. The frequencies of perforin and granzyme B expression in rejection group were 100% (19/19) and 94.7% (18/19), respectively. While those in no rejection group were 25.0% (4/16) and 12.5 (2/16), respectively. In most rejected samples, perforin and granzyme B were expressed simultaneously. Only three samples showed perforin expression alone, while no samples demonstrated granzyme B expression alone. There was a close relationship between perforiu/granzyme B expression and liver allograft rejection. Conclusion Perforin and granzyme B expression seemed to be related to the development of acute rejection following liver transplantation, and might be served as sensitive and reliable markers in diagnosing acute rejection in early stage.