112例慢性HBV感染免疫耐受期患者肝组织病理学特点

Characteristics of liver tissue pathology of 112 patients with chronic hepatitis B during immune tolerant phase

目的探讨处于免疫耐受期慢性HBV感染者的肝组织病理特点。方法回顾性分析112例慢性HBV感染免疫耐受期患者的临床病理资料及其肝组织炎症、纤维化程度以及HBcAg免疫组织化学的特点。结果 112例患者包括肝组织炎症G0期31例、G1期75例、G2期4例、G3～4期2例。肝组织纤维化S0期34例、S1期63例、S2期9例,S3～4期6例。肝组织免疫组织化学HBcAg分布,核型48例、混合型53例,浆型4例、阴性7例。不同性别、年龄组之间及ALT亚组间肝组织病理学差异无统计学意义(χ2分别为0.50、2.62、1.22,P均>0.05)。结论慢性HBV感染高HBVDNA载量(>107拷贝/ml)的免疫耐受期患者主要集中在年轻人群,其肝组织炎症及纤维化程度较轻微,HBcAg表达以核型和混合型为主。肝组织病理学损害与性别、年龄,ALT不同亚组间无相关性。

Objective To observe the characteristics of hepatic pathology of patients with chronic hepatitis B during the immune tolerant phase. Methods Total of 112 patients with chronic hepatitis B during the immune tolerant phase were analyzed, retrospectively. Combined with previous clinical research, liver tissue inflammation, fibrosis stage and distribution types of HBcAg by immunohistochemistry were discussed. Results The inflammation grades were G0 in 31 cases, G1 in 75 cases, G2 in 4 cases, G3～4 in 2 cases. The fibrosic stages were S0 in 34 cases, S1 in 63 cases, S2 in 9 cases, S3～4 in 6 cases. The distribution type of HBcAg by immunohistochemistry was 48 cases of nuclei type, 53 cases of mixed type, 4 cases of cytoplasm type and 7 negative cases. The difference of pathlogical characteristics among gender, age, subgroups （ALT less than 40 U/L） were not statistically significant （χ2 = 0.50, 2.62, 1.22; P 0.05）. Conclusions Patients during immune tolerant phase （HBV DNA 107 copies/ml） focuses on young people. The inflammation grades and fibrosic stages were minor. HBcAg mainly distributes in nuclei or mixed types. The difference of pathlogical characteristics among gender, age, subgroups （ALT ≤ 40 U/L） were not statistically significant.