CD38和MUM-1在自身免疫性肝炎中的表达及临床意义

Expression and clinical significance of CD38 and multiple myeloma oncogene 1 in autoimmune hepatitis

目的观察自身免疫性肝炎(AIH)患者肝穿刺组织中白细胞分化抗原38(CD38)和多发性骨髓瘤癌基因1(MUM-1)的表达,探讨其在AIH发生发展中的作用。方法以2017年1月-2018年12月无锡市第五人民医院病理科46例AIH患者肝穿组织作为实验组,以30例胆囊癌根治标本的正常肝组织为对照组,采用免疫组化法检测CD38和MUM-1的表达,并结合患者的临床和病理特征进行分析。非正态性计量资料2组间比较采用Wilcoxon秩和检验;计数资料2组间比较采用χ^2检验;相关性分析采用Spearman秩相关分析法。结果 46例AIH患者的CD38和MUM-1的阳性表达均高于对照组(Z值分别为-7.181、-7.484,P值均<0.001)。在AIH患者中炎症活动分级≥3级和纤维化4期CD38和MUM-1的阳性表达均显著增加,与炎症活动分级<3级和纤维化<4期相比,差异均有统计学意义(χ^2值分别为10.085、15.769、14.988、26.966,P值均<0.05)。CD38和MUM-1的表达与慢性炎症活动分级及纤维化分期呈显著正相关(r值分别为0.552、0.876、0.603、0.934,P值均<0.001),且CD38与MUM-1亦呈显著正相关(r=0.932,P<0.001)。结论 CD38和MUM-1参与AIH的炎症活动和纤维化形成过程,二者具有协同作用,影响肝硬化进程,有望成为未来诊断以及治疗的潜在靶标。

Objective To investigate the expression of the leukocyte differentiation antigen CD38 and multiple myeloma oncogene 1( MUM-1) in liver biopsy tissue of patients with autoimmune hepatitis( AIH),as well as their roles in the development and progression of AIH.Methods Liver biopsy tissue samples from 46 AIH patients who were admitted to Department of Pathology in Wuxi Fifth People’s Hospital from January 2017 to December 2018 were selected as experimental group,and normal liver tissue samples from 30 patients with gallbladder carcinoma who underwent radical treatment were selected as control group.Immunohistochemistry was used to measure the expression of CD38 and MUM-1,and an analysis was performed with reference to patients’ clinical and pathological features.The Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups,the chi-square test was used for comparison of categorical data between groups,and a Spearman correlation analysis was also performed.Results The experimental group had significantly higher expression of CD38 and MUM-1 than the control group( Z =-7.181 and-7.484,both P<0.001).The AIH patients with inflammatory activity grade ≥3 and fibrosis stage 4 had significant increases in the expression of CD38 and MUM-1,with significantly higher expression than those with inflammatory activity grade < 3 and fibrosis stage < 4(χ^2= 10.085,15.769,14.988,and26.966,all P<0.05).The expression of CD38 and MUM-1 was positively correlated with chronic inflammatory activity grade and fibrosis stage( r = 0.552,0.876,0.603,and 0.934,all P<0.001),and CD38 was also positively correlated with MUM-1( r = 0.932,P<0.001).Conclusion CD38 and MUM-1 are involved in the inflammatory activity of AIH and the process of fibrosis formation.There is a synergistic effect between them,which affects the process of liver cirrhosis.Therefore,they may become potential targets for diagnosis and treatment in future.