原发性胆汁性肝硬化和自身免疫性肝炎肝组织中浆细胞IgM和IgG的免疫组化检测

Detection of IgM and IgG in plasma cells of liver biopsy specimens from primary biliary cirrhosis and autoimmune hepatitis by immunohistochemistry

目的通过比较原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)和自身免疫性肝炎(autoimmune hepatitis,AIH)肝组织中浆细胞IgG和IgM的表达情况,探讨其在鉴别诊断中的价值。方法 37例肝活检组织标本中,PBC和AIH分别为17例和20例。采用免疫组化的方法显示肝组织活检标本汇管区中浆细胞IgM和IgG表达,通过半定量评分系统,评估、比较在连续切片相同部位的汇管区内IgM和IgG阳性表达的浆细胞数量,并进行统计学分析。结果 17例PBC标本中,15例汇管区的浆细胞显著表达IgM(88.2%),2例显著表达IgG(11.8%);而在20例AIH标本中2例浆细胞显著表达IgM(10.0%),18例显著表达IgG(90.0%),两种自身免疫性肝病肝组织浆细胞中IgM和IgG的表达率差异有显著统计学意义(P<0.0001)。结论肝组织中IgM和IgG的免疫组化检测有助于PBC和AIH的鉴别诊断。

Objective To study the expression of IgM and IgG in plasma cells of liver biopsy tissues from primary biliary cirrhosis（PBC） and autoimmune hepatitis（AIH） and to investigate its role in differentiating diagnosis between two diseases.Methods Seventeen and twenty biopsies cases from untreated patients diagnosed as PBC and AIH were examined by immunostaining with anti-polyclonal antibody for IgM and IgG.Positive expression in same portal tracts of IgM and IgG in plasma cells were detected with semiquantitative scoring.Results There were 15 cases（15 /17,88.2%） of PBC with predominantly expressing IgM in plasma cells of liver biopsy tissues and 18 cases（18 /20,90.0%） of AIH with predominantly expressing IgG（P 0.0001）.The expression of IgM was more prominent in the moderate and marked inflammatory biopsies than mild inflammatory biopsies in PBC（P 0.05） and also of IgG in AIH（P 0.05）.Conclusion Immunostaining detection for IgM and IgG in plasma cells of liver tissue can be helpful in differentiating PBC from AIH.