丙型病毒性肝炎患者肝组织Fas抗原的表达与HAI积分关系的研究

The relationship between Fas antigen in liver tissue and histological activity index in patients with hepatitis C

目的：研究丙型病毒性肝炎患者肝组织Ｆａｓ抗原的表达状况与肝细胞病理损伤的关系，探讨细胞凋亡在丙型肝炎发病机制中的作用和意义。方法：６９例丙型肝炎患者，均为血清抗－ＨＣＶＩｇＧ阳性或ＨＣＶＲＮＡ（ＰＣＲ）阳性，肝组织均为快速肝穿，福尔马林固定，连续切片，常规ＨＥ染色，按Ｋｎｏｄｅｌ方法计算ＨＡＩ积分前三项，根据Ｋｉｙｏｓｈｉ方法进行Ｆａｓ抗原半定量分析。结果：Ｆａｓ抗原在丙肝的阳性率为７４％，其中ＣＡＨ（８４．５％）。急肝（８３．４％）明显高于ＣＰＨ（６４．９％，Ｐ＜０．０５）。ＨＡＩ积分与Ｆａｓ抗原半定量分析显示，肝组织病理炎症积分越高，Ｆａｓ抗原表达量越高（Ｐ＜０．０５）。结论：Ｆａｓ抗原在丙型病毒性肝炎患者肝组织的表达与肝细胞的病理损伤明显相关。

Objective:To evaluate the possible role of apoptisis on liver injury in hepatitis C.Methods:The expression of Fas antigen in liver tissue were studied by immunohistochemical staining (SP method), meanwhile, the histological activity index (HAI) were analyzed by knodels method. Results:The Expression rate of Fas antigen in 69 patients infected with HCV was 74%, and the expression of Fas antigen was found mainly in the cytoplasm of hepatocytes. The positive staining cells were found particularly at the edges of piecemeal necrosis. Semiquatitative analysis revealed more expression of Fas antigen and higher HAI in liver tissues with active imflammalion than those without it ( P <0 05). Conclusion:Our findings suggest that Fas antigen expression plays an important role in the inflammatory process of hepatitis C, especiaely in the active inflammation stage. Apoptosis, mediated through Fas antigen may be a type of hepatocyte necrosis in heptitis C.