摘要
目的 对肝穿刺活检组织病变程度进行正确的分级、分期 ,并比较肝病理分级和分期之间的关系以及肝组织原位病毒抗原与血清学病毒标志物检测的差异。方法 上海市肝纤维化协作组提供肝穿刺组织 2 0 0例 ,由我室 3位病理医师按 1995年全国标准分别进行病理分级、分期 ,其结果行统计学Kappa检验 ,并分别采用PAP和ABC免疫酶标法对肝组织进行原位检测HBsAg、HBcAg及HCVAg(CP10 )。结果 3位病理医师分别进行的病理分级、分期的一致性极好 ,使其结果更具客观性和可信性 ;肝组织炎症活动性与肝纤维化程度密切相关 (P <0 .0 1) ;血清学HBV标志物的检出率明显高于组织中的原位检出率 ,而血清学HCV标志物的检出率却低于组织中HCV抗原的阳性率。结论 肝组织病变程度的正确分级、分期为本课题组早期肝纤维化病例建立非创伤性诊断指标提供了重要的保证。开展对肝组织HCV抗原的原位检测十分必要 ,将有利于对肝炎的病因学分类。
Objective To analyze precisely the grading and staging of inflammation and fibrosis in liver biopsies from patients with chronic hepatic disease and to explore their relationships, and the difference between the detection of viral markers in serum and in tissue.Methods The inflammatory activity and fibrosis of consecutive liver biopsies from 200 patients provided by the Liver Fibrosis Cooperation Organization of Shanghai were determined according to Chinese 1995 Diagnosis Criteria of Chronic Hepatitis by three experienced pathologists examined independently and the results were analyzed by Kappa test. HBsAg、HBcAg and HCV core protein (CP 10 ) were detected on paraffin sections by means of immunohistochemistry. Results The staging and grading of hepatic lesions independently given by the three pathologists had a good consistency, so the diagnoses were objective and reliable. There was a close relationship between the activity of inflammation and the degree of fibrosis ( P < 0.01 ). The positive rate of HBV markers in serum considerately higher than that in tissue, while the positive rate of HCV markers in serum was lower than that in tissue.Conclusion The correct grading and staging of hepatic lesions provide an important assurance for establishing noninvasive parameters in early hepatic fibrosis. The detection of tissue HCV antigen in sites is necessary and useful for etiological classification of viral hepatitis.
出处
《肝脏》
2000年第4期198-199,212,共3页
Chinese Hepatology
基金
上海市医学发展基金!重点研究项目 (编号 :No .99ZDI0 0 1 )
上海市肝纤维化课题