移植肾急性排斥组织中C4d CD3 CD4 CD8 CD138表达的初步研究

A research on C4d CD3 CD4 CD8 CD138 expression in tissues of acute renal allograft rejection

目的分析探讨移植肾急性排斥组织中C4d、CD3、CD4、CD8、CD138的表达。方法收集我院2010年3月至2013年10月经病理学确认为急性排斥反应移植肾穿刺标本136例,依据Banff 2007标准将研究对象分为5组,利用免疫组织化学染色计数测定各组C4d、CD3、CD4、CD8、CD138阳性表达情况并计算CD4/CD8值。结果急性抗体介导性排斥反应组C4d染色均为阳性,急性T细胞介导性排斥反应组C4d染色均为阴性;CD3、CD4、CD8阳性细胞数及CD4+/CD8+值急性T细胞介导性排斥反应组高于急性抗体介导性排斥反应组,差异有统计学意义(P<0.01),急性T细胞性排斥Ⅰ、Ⅱ级组高于疑为急性T细胞介导性排斥组,差异有统计学意义(P<0.01),急性T细胞性排斥Ⅱ级组高于急性T细胞性排斥Ⅰ级组,差异具有统计学意义(P<0.05),急性抗体介导性排斥反应Ⅰ级组与急性抗体介导性排斥反应Ⅱ级组差异无统计学意义(P>0.05);CD138阳性细胞急性抗体介导性排斥反应组大于急性T细胞介导性排斥反应组,差异有统计学意义(P<0.01),急性抗体介导性排斥反应Ⅱ级组高于急性抗体介导性排斥反应Ⅰ级组,差异具有统计学意义(P<0.05),急性T细胞介导性排斥反应3组比较,差异无统计学意义(P>0.05)。结论 C4d的表达和CD3、CD4、CD8、CD138阳性细胞数以及CD4+/CD8+值与肾移植急性排斥反应的类型及反应程度密切相关,检测C4d、CD3、CD4、CD8、CD138在移植肾急性排斥组织中表达情况,对于探讨移植肾早期急性排斥反应发生具有重要意义。

Objective To study the expression of C4d ,CD3＋ ,CD4＋ ,CD8＋ and CD138＋ in the tissue of a-cute renal allograft rejection .Methods One hundred and thirty-six cases of acute rejection of renal biopsy tissue were collected in our hospital from March 2010 to October 2013 ,which were divided into 5 groups according to Banff 2007 standard .Then ,the numbers of positive cells of CD3＋ ,CD4＋ ,CD8＋ and CD138＋ were counted and the values of CD4/CD8 of each group were calculated by immunohistochemical staining method to study the related positive expression .Results The results showed C4d staining was positive in acute antibody mediated rejection group while negative in acute T cell mediated rejection group .For the numbers of positive cells of CD3＋ ,CD4＋ , CD8＋ and the values of CD4/CD8 ,the results of acute T cell mediated rejection group were higher than that of a-cute antibody mediated rejection group .And the difference was statistically significant （P＆lt;0.01） .The results ofⅠ and Ⅱ groups of acute T cell mediated rejection were higher than that of acute T cell mediated rejection critical group and the difference was statistically significant （P＆lt;0.01） ,and the results of Ⅱ group of acute T cell media-ted rejection were higher than that of Ⅰ group and the difference was statistically significant （P＆lt;0.05） ,while the results ofⅠgroup of acute antibody mediated rejection has no significant difference compared with Ⅱ group （P＆gt;0.05） .Nevertheless ,for the numbers of positive cells of CD138＋ ,the results of acute antibody mediated rejec-tion group were higher than that of acute T cell mediated rejection group and the difference was statistically signifi-cant （P＆lt; 0.01） ,and the results of Ⅱ group of acute antibody mediated rejection were higher than that of Ⅰgroup and the difference was statistically significant （P＆lt;0.05） ,while the results had no significant difference （P＆gt;0.05） among three groups of acute T cell mediated rejection .Conclusion The expression of C4d ,the numbers of positive cells of CD3＋ ,CD4＋ ,CD8＋ and CD138＋ and the value of CD4/CD8 are closely related to the type and extent of reaction of acute rejection of renal transplantation .Studies of the expression of C4d ,CD3 ,CD4 ,CD8 , CD138 in acute renal allograft rejection tissues would be significant to predict the occurrence of acute rejection .