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目的在乙型肝炎病毒(HBV)所致的终末期肝病患者肝组织内,常可见大量的胆管增生,但其发生机制及临床意义尚不清楚。为阐明该类患者胆管增生的发生机制及其与卵圆细胞增生及肝细胞再生的关系,我们对8例HBV相关的终末期肝病患者及2例正常人肝组织进行了免疫组化染色及图像分析。方法肝组织连续切片后进行免疫组化染色,观察指标为细胞角蛋白(CK)7、CK8、CK19、OV6、增殖细胞核抗原(PC-NA)、甲胎蛋白(AFP)及白蛋白(ALB)。结果在所有8例患者肝组织汇管区内均可见典型增生的胆管及非典型增生的胆管,且对CK7、CK8、CK19、OV6及PCNA染色呈阳性反应,但两种类型的胆管在染色强度上存在明显差异。一些非典型增生的胆管细胞表现出肝卵圆细胞的形态学及免疫组化特征。某些小型肝细胞样细胞在形态及免疫组化特征方面介于肝卵圆细胞及成熟肝细胞之间。结论在HBV相关的终末期肝病患者肝组织内,胆管增生可能存在不同起源。某些非典型增生的胆管细胞实际上就是活化的肝卵圆细胞。非典型增生的胆管细胞与肝细胞再生密切相关。小型肝细胞样细胞可能是肝卵圆细胞与成熟肝细胞之间的中间过渡细胞。
Objective To detect a large number of bile duct hyperplasia in the liver tissue of patients with end-stage liver disease caused by hepatitis B virus (HBV), but its mechanism of occurrence and clinical significance are not yet clear. To clarify the pathogenesis of bile duct hyperplasia and its relationship with oval cell proliferation and hepatocyte regeneration in this group of patients, 8 cases of HBV-related end-stage liver disease and 2 cases of normal liver tissue were immunohistochemically stained and imaged analysis. Methods The sections of liver were stained with immunohistochemistry and the indexes were cytokeratin (CK) 7, CK8, CK19, OV6, PC-NA, AFP and ALB, . Results In all 8 patients, typical hyperplastic bile duct and atypical hyperplastic biliary duct were seen, and positive staining for CK7, CK8, CK19, OV6 and PCNA were observed. However, the two types of bile duct in staining intensity There are obvious differences. Some atypical hyperplastic cholangiocytes exhibit morphological and immunohistochemical features of hepatic oval cells. Some small hepatocyte-like cells are intermediate between hepatic oval cells and mature hepatocytes in morphological and immunohistochemical characteristics. Conclusion There may be different origins of bile duct hyperplasia in the liver tissue of patients with HBV-related end-stage liver disease. Some atypical hyperplastic cholangiocytes are actually activated hepatic oval cells. Atypical hyperplastic cholangiocytes are closely related to hepatocyte regeneration. Small hepatocyte-like cells may be intermediate transition cells between hepatic oval cells and mature hepatocytes.