慢性乙型肝炎患者肝脏树突状细胞和淋巴细胞亚群与病程的关系

目的:探讨慢性乙型肝炎患者局部免疫状况与患者病程的关系。方法:选取64例慢性肝炎患者的肝脏石蜡标本。免疫组化方法检测CD4+T、CD8+T淋巴细胞和树突状细胞,分析免疫细胞的类型、数目及分布与病程的关系。结果:免疫组化结果显示CD4+T细胞多见于汇管区,CD4+T细胞数量少于CD8+T细胞数量。树突状细胞形态不规则,绝大部分分布于坏死灶和汇管区间质中与淋巴细胞伴行。淋巴细胞浸润越多的病例中树突状细胞也越多。CD4+T、CD8+T淋巴细胞的数量与病程具有相关性。慢性乙型肝炎随着病程的延长,病情的加重,即G1-G4、S1-S3的发展中,肝脏组织中CD4+T、CD8+T、DC的数量逐渐增加,但当发生肝硬化时(S4),三者的数量减少。结论评价慢性肝炎肝脏免疫微环境状况应当综合评价免疫细胞的类型、亚型和功能状态及相互作用等多种因素,在分析、判断疾病进程和治疗上有一定意义。

Relationship between Dendritic Cells and Lymphocyte Subpopulation in Liver and Prognosis of Patiens with Chronic Hepatitis B

Objective To investigate the relationship between distribution and quantity of dendritic cells(DC)and subgroup lymphocytes in CHB and prognosis of patiens with CHB.Methods immunohistochemisty was performed on 64 specimens of patiens with chronic Hepatitis B to count the S-100 protein positive DC and CD4 T,CD8 T in ten high power fields within a specimen.and to observe the relationship between prognosis of patiens and the types,the quantity and the distributing of Immunocytes.Results:Immunohistochemical results showed that CD4 T exist in the portal areas,but the CD4 T is not as mush as CD8 T And the shape of the DCs is irregular.Almost all of the DCs distribute in areas of necrosis and interstitial with Lymphocytes.The number of DC is much more in the cases of those that have more necroareas and Lymphocytes infiltration.The Progress and the number of CD4 T and CD8 T have positive relationship.in the case of CHB,the number of CD4 T CD8 T,and DCs of the liver was increase in the process from G1 to G4/S1 to S3,but decreased in S4.Conclusion:We should consider the type,Lymphocyte Subpopulation,the function and relationship of the immunologic cells and evaluating the Immune-micro-environment of chronic hepatitis.