主要组织相容性复合物Ⅰ类抗原在特发性炎性肌病中的表达研究

Study of expression of major histocompability complex Ⅰ antigen in idiopathic inflammatory myopathies

目的探讨主要组织相容性复合物Ⅰ类抗原(MHC-Ⅰ)在特发性炎性肌病(IIM)中的表达及其意义。方法对15例IIM患者(IIM组,多发性肌炎14例、皮肌炎1例)、23例其他肌病患者(OM组,肢带型肌营养不良18例、脂质沉积性肌病4例、糖原累积性肌病1例)及5例无肌病对照者(NC组)的骨骼肌标本进行MHC-Ⅰ免疫组化染色。结果NC组未见MHC-Ⅰ表达;IIM组肌纤维MHC-Ⅰ阳性率为86.7%(13/15),明显高于OM组(26.1%,6/23)(P<0.005)。IIM组MHC-Ⅰ阳性表达的敏感性为86.7%,95%CI:59%～98%;特异性为73.9%,95%CI:55%～91%。结论 IIM患者肌纤维MHC-Ⅰ阳性表达高。MHC-Ⅰ免疫组化染色是一种较好的辅助IIM病理诊断的方法。

Objective To study the expression and its meaning of major histocompability complex Ⅰ （MHC- Ⅰ） antigen in idiopathic inflammatory myopathy （IIM） . Methods The MHC-Ⅰ antigen was detected by immunohistochemistry in muscle samples of 15 patients with IIM （IIM group,including 14 cases of polymyositis and 1 case of dermatomyositis） ,23 patients with other myopathies （OM group,including 18 cases of limb-girdle muscular dystrophy,4 cases of lipid storage myopathy and 1 case of glycogen storage myopathy） and 5 normal controls without myopathy （NC group） . Results There was no expression of MHC-Ⅰ in NC group. The positive rate of MHC-Ⅰ antigen was 86. 7% （13 /15） in IIM group,which was significantly higher than in OM group （26. 1% ,6 /23） （P 0. 005） . The sensitivity of MHC-Ⅰ in IIM group was 86. 7% ,95% CI： 59% - 98% ; and the specificity of MHC-Ⅰ in IIM group was 73. 9% ,95% CI： 55% - 91% . Conclusions The positive expression of MHC-Ⅰ is high in IIM patients. The immunohistological chemistry staining of MHC-Ⅰ can be a good pathological diagnostic method for IIM.