D-PAS、IgG、IgM、PDC-E2和CD11c在自身免疫性肝病的表达和应用研究
发布时间：2018-10-22 07:52
【摘要】：[目的] 研究自身免疫性肝病的病理特点,寻找有效的病理诊断指标。 [方法] 选择2006年—2012年昆明医科大学病理教研室肝穿活检病例1883例,从中筛选病理诊断为原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)血清检测AMA-M2阳性病例30例、AMA-M2阴性17例和自身免疫性肝炎(autoimmune hepatitis,AIH)病例20例。采用D-PAS特殊染色观察门管区的病变情况,采用免疫组化方法检测肝组织内IgG、IgM、PDC-E2、 CD11c的表达情况。 [结果] 1、D-PAS特殊染色能勾勒出胆管上皮基底膜的轮廓,有利于了解门管区胆管的损伤情况。 2、免疫组化检测显示： IgM、IgG阳性颗粒主要分布于肝脏门管区浆细胞胞浆内,PDC-E2阳性颗粒表达于胆管上皮细胞及肝细胞的胞浆内,CDllc阳性颗粒表达于肝脏门管区树突状细胞的胞浆内。PBC AMA-M2阳性组、PBC AMA-M2阴性组、AIH组三组内IgM、IgG含量相比差异均有统计学意义(P0.05), PBC患者肝脏门管区浆细胞内主要表达IgM, AIH患者肝脏门管区浆细胞内主要表达IgG,; PBC AMA-M2阳性组与AMA-M2阴性组相比,AMA-M2阳性的PBC患者肝脏门管区IgM、IgG阳性表达比AMA-M2阴性的PBC患者的高,IgM、IgG含量差异有统计学意义(P0.05)。PBC AMA-M2阳性组、PBC AMA-M2阴性组、AIH组两两相比,PDC-E2阳性单位相比差异均有统计学意义(P0.05)。PBC AMA-M2阳性组、PBC AMA-M2阴性组、AIH组两两相比,PBC AMA-M2阳性组、PBCAMA-M2阴性组CD11c阳性单位相比差异无统计学意义(P0.05),余两两相比CD11c阳性单位差异有统计学意义(P0.05)。 [结论] 1、D-PAS特殊染色能显示肝脏门管区胆管基底膜的损伤情况,并且更直观的显示胆管数目的增减情况。 2、PBC患者肝脏门管区浆细胞内主要表达IgM, AIH患者肝脏门管区浆细胞内主要表达IgG,肝组织中IgM和IgG的检测及分析有助于自身免疫性肝病的诊断。且AMA-M2阳性的PBC患者肝脏门管区IgM.IgG阳性表达比AMA-M2阴性的PBC患者的高。 3、肝穿活检组织PDC-E2免疫组化检测有助于PBC的诊断,且在AMA-M2阳性和AMA-M2阴性的PBC的表达有一定的差异。 4、CD11c主要表达于肝脏门管区肉芽肿内,有助于PBC的诊断。
[Abstract]:Objective: to study the pathological features of autoimmune liver disease and to search for effective pathological diagnosis index. [methods] 1883 cases of liver biopsy were selected from 2006 to 2012 in the Department of Pathology, Kunming Medical University. Thirty cases of AMA-M2 positive, 17 cases of AMA-M2 negative and 20 cases of autoimmune hepatitis (autoimmune hepatitis,AIH) were screened from pathological diagnosis of primary biliary cirrhosis (primary biliary cirrhosis,PBC). The results were as follows: (1) there were 30 cases of AMA-M2 positive, 17 cases of AMA-M2 negative and 20 cases of autoimmune hepatitis (autoimmune hepatitis,AIH). The pathological changes of portal area were observed by D-PAS staining and the expression of IgG,IgM,PDC-E2, CD11c in liver tissue was detected by immunohistochemical method. [results] 1D-PAS special staining could outline the basal membrane of bile duct epithelium. 2Immunohistochemical examination showed that IgM,IgG positive granules were mainly distributed in the cytoplasm of hepatic hilar duct plasma cells, and PDC-E2 positive granules were expressed in bile duct epithelial cells. CDllc positive granules were expressed in the cytoplasm of dendritic cells in hepatic portal area. There were significant differences in IgM,IgG content among three groups: PBC AMA-M2 positive group, PBC AMA-M2 negative group and AIH group (P0.05). Compared with AMA-M2 negative group, the positive expression of IgM,IgG in AMA-M2 positive PBC patients was higher than that in AMA-M2 negative PBC patients, and IgM,IgG content was different. Statistical significance (P0.05). PBC AMA-M2 positive group, PBC AMA-M2 negative group, AIH group compared with each other, PDC-E2 positive group, PBC AMA-M2 negative group, AIH group, PBC AMA-M2 positive group, PBCAMA-M2 negative group CD11c positive unit difference was statistically significant (P0.05). There was no statistical significance (P0.05), the other two compared with the CD11c positive unit difference was statistically significant (P0.05). [conclusion] 1D-PAS special staining can show the damage of bile duct basement membrane in hepatic hilar area. The expression of IgM and IgG in liver tissues of patients with IgM, AIH was mainly detected and analyzed. Assist in the diagnosis of autoimmune liver disease. The positive expression of IgM.IgG in PBC patients with AMA-M2 positive was higher than that in PBC patients with AMA-M2 negative. The immunohistochemical detection of PDC-E2 in liver biopsy tissue was helpful for the diagnosis of PBC. The expression of CD11c was mainly expressed in hepatic hilar granuloma, which was helpful for the diagnosis of PBC.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575
本文编号：2286558
[Abstract]:Objective: to study the pathological features of autoimmune liver disease and to search for effective pathological diagnosis index. [methods] 1883 cases of liver biopsy were selected from 2006 to 2012 in the Department of Pathology, Kunming Medical University. Thirty cases of AMA-M2 positive, 17 cases of AMA-M2 negative and 20 cases of autoimmune hepatitis (autoimmune hepatitis,AIH) were screened from pathological diagnosis of primary biliary cirrhosis (primary biliary cirrhosis,PBC). The results were as follows: (1) there were 30 cases of AMA-M2 positive, 17 cases of AMA-M2 negative and 20 cases of autoimmune hepatitis (autoimmune hepatitis,AIH). The pathological changes of portal area were observed by D-PAS staining and the expression of IgG,IgM,PDC-E2, CD11c in liver tissue was detected by immunohistochemical method. [results] 1D-PAS special staining could outline the basal membrane of bile duct epithelium. 2Immunohistochemical examination showed that IgM,IgG positive granules were mainly distributed in the cytoplasm of hepatic hilar duct plasma cells, and PDC-E2 positive granules were expressed in bile duct epithelial cells. CDllc positive granules were expressed in the cytoplasm of dendritic cells in hepatic portal area. There were significant differences in IgM,IgG content among three groups: PBC AMA-M2 positive group, PBC AMA-M2 negative group and AIH group (P0.05). Compared with AMA-M2 negative group, the positive expression of IgM,IgG in AMA-M2 positive PBC patients was higher than that in AMA-M2 negative PBC patients, and IgM,IgG content was different. Statistical significance (P0.05). PBC AMA-M2 positive group, PBC AMA-M2 negative group, AIH group compared with each other, PDC-E2 positive group, PBC AMA-M2 negative group, AIH group, PBC AMA-M2 positive group, PBCAMA-M2 negative group CD11c positive unit difference was statistically significant (P0.05). There was no statistical significance (P0.05), the other two compared with the CD11c positive unit difference was statistically significant (P0.05). [conclusion] 1D-PAS special staining can show the damage of bile duct basement membrane in hepatic hilar area. The expression of IgM and IgG in liver tissues of patients with IgM, AIH was mainly detected and analyzed. Assist in the diagnosis of autoimmune liver disease. The positive expression of IgM.IgG in PBC patients with AMA-M2 positive was higher than that in PBC patients with AMA-M2 negative. The immunohistochemical detection of PDC-E2 in liver biopsy tissue was helpful for the diagnosis of PBC. The expression of CD11c was mainly expressed in hepatic hilar granuloma, which was helpful for the diagnosis of PBC.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575
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