苦味酸-天狼星红偏振光法在早期肝纤维化诊断中的应用

Application of picrosirius polarization method in diagnosis of early hepatic fibrosis

目的 探讨早期肝纤维化诊断的特异性方法。方法 应用苦味酸天狼星红偏振光法对早期纤维化肝组织中胶原的性质及分布特点进行观察。结果 偏振光显微镜下可见随肝纤维化程度的不同清晰地显示嗜酸性胶原蛋白纤维束 ,其中Ⅰ型胶原纤维 (colⅠ )为粗大明亮的黄或红色纤维 ,显示很强的双折光性 ;Ⅲ型胶原纤维 (colⅢ )为绿色细纤维 ,呈疏网状 ,显示弱的双折光。经图像分析 ,其中S1期肝组织中colⅠ占 (10 5 8± 2 33) % ,colⅢ占(45 13± 2 6 7) % ;S2期肝组织中colⅠ占 (5 0 12± 2 5 8) % ,colⅢ占 (48 5 5± 1 6 6 ) %。结论 苦味酸天狼星红染色和偏振光法可确定肝纤维化组织胶原类型、分布、排列与含量 ,是明确早期肝纤维化分期较理想方法。

Objective To find a specific method to diagnose early hepatic fibrosis. Methods The content and distribution of collagen in human early fibrotic liver were observed with both conventional light and polarization microscopy combined with image analysis and picrosirius-red staining. Results Polarization microscopy revealed acidophilia collagen fibrils of type I that showed either red or yellow intense birefringence in the liver tissue, whereas type Ⅲ collagen fibers consisted mainly of green thin fibril with weak greenish birefringence. As indicated by image analysis, the liver tissue of stage S1 contained (10.58±2.33)% type Ⅰ collagen and (45.13±2.67)% type Ⅲ collagen; The liver tissue of stage S2 contained (50.12±2.58)% type Ⅰ collagen and (48.55±1.66)% type Ⅲ collagen. Conclusion Polarization microscopy and picrosirius red staining is an ideal method in analyzing the distribution and arrangement of the collagen in fibrotic liver, and can be used to define the early stages of fibrotic liver.