移植肝组织淋巴细胞表型分析对急性排斥反应诊断的价值

目的 检测移植肝组织浸润淋巴细胞的免疫表型,分析不同表型淋巴细胞数量及其分布与并发症的关系.方法 应用CD8、CD4、CD3、CD20、CD45RO及CD45RA单抗对108例次移植肝活检组织进行免疫组化染色,对比形态学观察,分析不同区域浸润淋巴细胞的免疫表型.结果 排斥组62例次,非排斥组46例次.排斥组汇管区CD3 、CD8 、CD20 细胞浸润程度均显著高于非排斥组(P＜0.01),两组间各型淋巴细胞在小叶内浸润程度均无显著差异(P＞0.05).排斥反应组中,CD8 细胞浸润程度显著高于CD4 细胞(P＜0.05).排斥组CD3 、CD8 、CD45RO 细胞胆管或血管浸润率显著高于非排斥组(P＜0.01).排斥组中,汇管区CD8 和CD45RO 细胞浸润程度与排斥反应组织学分级显著相关(r值分别为7.481,9.103,P＜0.01).结论 移植肝活检组织中淋巴细胞免疫学分型对排斥反应的诊断和鉴别诊断具有一定的指导意义.

Value of lymphocyte immunophenotype of liver allograft in diagnosis of acute cellular rejection

Objective To investigate the lymphocyte immunophenotype in liver allograft and analyze the relationship between complications and the distribution or quantity of different lymphocytes. Methods Liver allograft specimens for biopsy were immunocytochemically stained for CD8, CD4, CD3, CD20, CD45RO and CD45RA. Lymphocyte immunophenotype was analyzed in different regions based on the liver morphology. Results Totally 108 specimens were collected, 62 diagnosed as acute cellular rejection (ACR group) and 46 as other complications (non-ACR group). CD3 cells, CD8 cells and CD20 cells of ACR group were significantly more than those of non-ACR group in portal tract (P<0.01), but not significantly different in lobule (P>0.05). In ACR group, CD8 cells were significantly more than CD4 cells in both portal tract and lobule (P<0.05). CD8 cells, CD3 cells and CD45RO cells infiltrated ducts or vessels in ACR Group more easily than those in nonACR group (P<0.01). The amount of CD8 cells and CD45RO cells was related to the degree of ACR. Conclusion The lymphocyte immunophenotype detection in liver allograft specimens is helpful in pathologic diagnosis and differential diagnosis of acute cellular rejection.