肝硬化肝组织中纤维组织的分布研究及其意义

Distribution and Ii's Significance of Fibrous Tissue in Human Liver Tissues of Patients with Cirrhosis.

目的:研究胶原纤维、网状纤维在肝硬化组织中的分布及其临床意义。方法:采用Masson染色和Gordon-Sweet染色对30例(HBSAg阳性)肝硬化组织和1例大致正常肝组织进行胶原纤维和网状纤维染色显示;用CMIAS-8计算机图像分析系统对胶原纤维和网状纤维进行面密度测定。结果:胶原纤维主要位于汇管区、纤维隔、炎症区、毛细血管、毛细胆管周围,肝窦内也可见胶原纤维存在,总阳性率50%,在肝炎后肝硬化组与原发性肝细胞癌外周肝硬化组之间差异无显著性(P >0.05);网状纤维的分布与胶原纤维相似,且实质细胞周围也存在。18例原发性肝细胞癌外周肝硬化组织有13例(72.2%)癌细胞区Gordon-Sweet染色阴性;肝炎后肝硬化组与原发性肝细胞癌外周肝硬化组之间胶原纤维和网状纤维分布的差异有极其显著性(P <0.01)。结论:肝硬化组织中胶原纤维和网状纤维明显增多,尤其在原发性肝细胞癌外周肝硬化组更明显;肝窦内的胶原纤维可能与肝窦毛细血管化有关;Gordon-Sweet染色可作为原发性肝细胞癌的辅助诊断。

Objective To investigate the distribution and its clinic significance of collagen fiber and reticular fiber in human liver tissues of patients with cirrhosis. Methods collagen fiber was detected by Masson`s staining and reticular fiber was detected by Gordon-Sweet staining in human liver tissues of 30 patients(HBs-Ag positive) with cirrhosis and 1 normal liver tissue on the whole . Parameters, area density(AD) for collagen fiber and reticular fiber, were measured by CMIAS-8 computer image analysis system. Results 1: Collagen fibermainly lay in portal areas?fiber septation ?inflammation areas?circu-mference around blood capillary and cholangioles. Collagen fiber also existed in hepatic sinusoid, total positive rate 50%. There was not prominent difference(P >0.05) between group posthepatitic cirrhosis and group primary hepatocellular carcinoma ; Distribution of reticular fiber was similar to of collagen fiber and reticular fiber existed around hepatocyte circumference. There was 72.2% (13 of 18) negative in carcinoma cell zona by Gormon-Sweet staining in group primary hepatocellular carcinoma; There was prominent differences(P <0.01) in distribution of collagen fiber and reticular fiber between group posthepatitic cirrhosis and group primary hepatocellular carcinoma. Conclusions Distribution of collagen fiber and reticular fiber increased in human liver tissues of cirrhosis,especially in primary hepatocellular carcinoma; It is probable that collagen fiber was associated with sinusoid capillarization ; Gordon-Sweet staining must be recommended as assist diagnosis of primary hepatocellular carcinoma.