慢性HBV携带者肝组织PD-1表达的临床意义

目的探讨肝脏组织中程序性死亡分子1（programmed death-1,PD-1）表达在慢性HBV携带者病情进展中的作用。方法选择慢性HBV携带者病例50例为研究对象,均予以血生化、病毒DNA、肝纤维化指标检测;患者肝穿刺活检后肝脏组织进行病理HE染色,观察肝脏组织炎症和纤维化的表现,并根据炎症结果将50例分为：A组：炎症0级;B组：炎症≥1级。免疫组化检测肝组织PD-1表达。结果根据炎症结果病例分为两组：A组26例（炎症G0）和B组24例（炎症≥G1）。病理分级炎症≥G2或纤维化≥S2的例数为15例。两组患者4种血清肝纤维化指标水平均无统计学差异。与A组比较,B组肝脏PD-1表达水平明显高（P〈0.05）。PD-1表达与肝纤维化分级相关性分析结果呈正相关。结论慢性HBV携带者肝脏组织PD-1表达水平越高,炎症及纤维化进展的可能性越大,肝脏PD-1表达可作为慢性HBV携带者病程进展的评估指标之一。

Clinical significance of expression of hepatic tissue PD-1 for chronic HBV carriers

Objective To explore the effect of expression of programmed death-1（PD-1） in hepatic tissues on disease progress for chronic HBV carriers. Methods Fifty chronic HBV carriers were selected as research subjects and received blood tests, including blood biochemistry, viral DNA and indices of hepatic fibrosis. After liver biopsy, HE staining was used in histopathology for hepatic tissues. Expression of hepatic tissue inflammation and fibrosis were observed, and the 50 patients were allocated to two groups based on the results of inflammation, group A for inflammation level G0 and group B for inflammation level ≥G1. Expression of PD-1 in hepatic tissues was shown according to immunohistochemical test. Results The patients were allocated to two groups on the basis of inflammation results, 26 patients in group A（inflammation level G0） and 24 patients in group B（inflammation level≥G1）. 15 patients showed the pathological grading at G2 or S2 and above. There were no statistically significant differences in 4 types of serum fibrosis indices between two groups. Compared with group A, expression level of hepatic PD-1 in group B was significantly higher（P0.05）. There was a positive correlation between PD-1 expression and fibrosis staging. Conclusion The higher the expression level of PD-1 in hepatic tissues for chronic HBV carriers, the greater the possibility of the progress of inflammation and fibrosis. Therefore, PD-1 expression can be used as one of the evaluation indices for disease progress of chronic HBV carriers.