慢性乙型肝炎病毒感染者肝组织中程序性死亡分子-1及其配体的表达

PD-1/PD-L1 expressions in liver tissues of patients with chronic HBV infection

目的 通过比较慢性HBV感染免疫耐受期和免疫清除期的患者肝组织中程序性死亡分子-1及其配体的表达情况,探讨其与机体免疫功能状态的关系.方法 收集肝组织活体检查标本并分为免疫清除期组25例、免疫耐受期组19例,用免疫组织化学方法检测标本汇管区中T淋巴细胞程序性死亡分子-1及其配体的表达情况,通过半定量评分系统计算其占CD3阳性细胞的百分数,用t检验比较两组病例间程序性死亡分子-1及其配体表达的差异.结果 免疫耐受期组肝组织汇管区T淋巴细胞中程序性死亡分子-1所占CD3阳性细胞比率为63.79%±6.94%,高于免疫清除期的54.36%±10.08%,两组比较,t=3.492,P〈0.01,差异有统计学意义;程序性死亡分子配体-1于T淋巴细胞中的表达在免疫耐受期组（66.47%±8.40%）中高于免疫清除期组（52.64%±6.20%）,两组比较,t=6.288,P〈0.01,差异有统计学意义.程序性死亡分子配体-1在枯否细胞中的表达强度及范围在两组间差异无统计学意义（P〉0.05）.结论 慢性HBV感染者肝组织中的程序性死亡分子-1及其配体表达水平的差异反映了免疫耐受期和免疫清除期的不同免疫功能状态.

Objective To detect and compare the PD- 1/PD-L1 （programmed death 1/programmed death 1 ligand） expressions in the liver tissues of chronic HBV infection patients in immune tolerant phase and those in immune clearance phase. Methods Liver biopsy samples were divided into two groups： 25 samples from patients in immune clearance phase and 19 samples from patients in immune tolerant phase.PD-1/PD-L1 expressions on T lymphocytes in these liver biopsy specimens were detected by immunobis tochemistry method. Percentage of PD-1/PD-L1 positive cells among CD3 positive cells was calculated by semi-quantitative evaluation. Differences between the two groups were statistically analyzed. Results PD1/PD-L1 expressions were significantly higher in the patients in immune tolerant phase as compared to that in immune active phase （P 〈 0.05）. No statistical difference found between the two groups for PD-L1 expression in Kupffer cells （P 〉 0.05）. Conclusion PD-1/PD-L1 expression level can reflect the immune functions of chronic hepatitis B patients.