门脉高压症巨脾HE染色组织形态测量学分析及病理分级探讨

HISTOLQGICAL CLASSIFICATION AND MORPHOMETRIC ANALYSIS OF DIFFERENT FIBROSIS SPLENOMEGALIES STAINED WITH H.E.

本文目的在于建立一个巨脾的HE染色片病理分析系统,以便能将组化、免疫组化和电镜下研究的结果更方便地应用于临床。结果表明:形态测量11项指标中有8项巨脾与外伤脾有显著差异,按纤维化综合分级比较,这种差异主要是Ⅰ级与Ⅱ、Ⅲ级间差异,Ⅰ级与外伤脾无显著差异。将上述指标以聚类分析作为聚类分级。与纤维化综合分级作合谐性分析,证明总符合率为84%。将11项指标作相关分析后,筛选出白髓面积百分比,脾小体和动脉周围淋巴鞘个数和(单位面积)以及生发中心比例三项指标,制定了巨脾HE染色片分级标准。并证实仅31%巨脾属病理Ⅰ级有保留价值。

In the series study of histological classification for splenomegaly, a creteria of it was made according to three type of fibers proliferation. This study made an immunohistological and morphometric analysis to observe the T, B lymphocytes and macrophages in splenomegaly of portal hypertension, in order to judge the changes of immunological function; investigate the number, distribution and morphology of T, B lymphocytes and macrophages; assess its regularity and relation between each other, as well as different fibrosis degrees. The study found that. ( 1 ) Compared with control group, all of T, B and macrophages in splenomegaly were significantly decreased, which were mainly class Ⅱ and Ⅲ of splenomegaly, and class Ⅰ was similar to control. ( 2 ) The same pattern of cells at different area decreased in different degree, it is at marginal zone that the changes were markable, where all of three patterns of cells decreaed significantly. ( 3 ) The relation of cells changes at marginal zone were different, it is linear relation between T and B, but is not between them and macrophages.