Pathological differential diagnosis of inflammatory liver injury
-
摘要: 不明原因导致的肝脏炎症性损伤一直都是临床的鉴别难点,简要回顾了引起炎症性肝损伤的各种肝脏疾病的病理改变,包括HE染色后光镜下的共同/特异表现,免疫组化、特殊染色在鉴别诊断中作用。此外,介绍了几种前沿的免疫组化抗体,为炎症性肝损伤的病理鉴别诊断提供了更有效的手段。Abstract: Unexplained liver inflammatory injury has always been a difficult point in clinical differential diagnosis. This article briefly reviews the pathological changes of various liver diseases that cause inflammatory liver injury, including common/specific findings under a light microscope after HE staining, and the role of immunohistochemistry and special staining in differential diagnosis. In addition, this article introduces several frontier immunohistochemical antibodies and provides more effective methods for the pathological differential diagnosis of inflammatory liver injury.
-
Key words:
- liver inflammatory injury /
- pathology /
- immunohistochemical /
- diagnosis, differential
-
[1]WANG TL, ZHANG TH.Advances in pathological classification of viral hepatitis[J].Chin J Pathol, 1996, 25 (2) :67-69. (in Chinese) 王泰龄, 张泰和.病毒性肝炎病理分类的进展[J].中华病理学杂志, 1996, 25 (2) :67-69. [2] ZHANG TH, ZHOU XJ.Pratical tiver pathology[M].Shanghai:Shanghai Scientific and Technological Literarure Press, 1995. (in Chinese) 张泰和, 周晓军.实用肝脏病理学[M].上海:上海科技文献出版社, 1995. [3]WANG EB.New trends in diagnosis, grading and staging of chronic hepatitis[J].Chin J Hepatol, 1995, 3 (1) :4-6. (in Chinese) 王恩宝.慢性肝炎的诊断、分级与分期的新动态[J].中华肝脏病杂志, 1995, 3 (1) :4-6. [4]ZHOU GD, ZHAO YL, ZHAO JM, et al.Hepatic steatosis associated with the progression of chronic hepatitis C[J/CD].Chin J Clinicians:Electronic Edition, 2012, 6 (6) :1470-1472. (in Chinese) 周光德, 赵雨来, 赵景民, 等.肝脂肪变性促进慢性丙型肝炎病程进展的研究[J/CD].中华临床医师杂志:电子版, 2012, 6 (6) :1470-1472. [5]ZHANG P, ZHAO XY.Clinical characteristics of chronic HBV/HCV infection complicated with mild fatty liver disease[J].Heilongjiang Med Pharm, 2017, 40 (5) :140-141. (in Chinese) 张盼, 赵晓迎.慢性HBV/HCV感染合并轻度脂肪肝病变的临床特点分析[J].黑龙江医药科学, 2017, 40 (5) :140-141. [6]ZHANG TH, ZHOU XJ.Research status ot HCV pathomorphology[J].Infect Dis Info, 1995, 8 (4) :156. (in Chinese) 张泰和, 周晓军.丙型病毒性肝炎病理形态的研究现状[J].传染病信息, 1995, 8 (4) :156. [7]KLEINER DE.The histopathological evaluation of drug-induced liver injury[J].Histopathology, 2017, 70 (1) :81-93. [8]DU HJ.Clinical and histopathological features of drug-induced liver injury and the role of immunocyte[D].Hebei:Hebei Med Univ, 2016:1-27. (in Chinese) 杜慧娟.药物性肝损伤的临床病理学特点及免疫细胞在发病中作用的研究[D].河北:河北医科大学, 2016:1-27. [9]ZHOU XJ, ZHANG LH.Diagnostic pathology of liver disease[M].Nanjing:Phoenix Science Press, 2006. (in Chinese) 周晓军, 张丽华.肝脏诊断病理学[M].南京:江苏科学技术出版社, 2006. [10]HENNES EM, ZENIYA M, CZAJA AJ, et al.Simplified criteria for the diagnosis of autoimmune hepatitis[J].Hepatology, 2008, 48 (1) :169-176. [11]JAING LL.Expression of MUM-1 and CD138 in autommune hepatitis and its significance[D].Suzhou:Soochow Univ, 2015:1-36. (in Chinese) 蒋丽琳.MUM-1和CD138在自身免疫性肝炎中的表达及其临床意义[D].苏州:苏州大学, 2015:1-36. [12] Chinese Society of Hepatology, Chinese Medical Association;Chinese Society of Gastroenterology, Chinese Medical Association;Chinese Society of Infectious Diseases, Chinese Medical Association.Consensus on the diagnosis and management of primary biliary cirrhosis (cholangitis) (2015) [J].J Clin Hepatol, 2015, 31 (12) :1980-1988. (in Chinese) 中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会.原发性胆汁性肝硬化 (又名原发性胆汁性胆管炎) 诊断和治疗共识 (2015) [J].临床肝胆病杂志, 2015, 31 (12) :1980-1988. [13]YOU Z, WANG Q, BIAN Z, et al.The immunopathplogy of liver granulomas in primary biliary cirrhosis[J].J Autoimmun, 2012, 39 (3) :216-221. [14]KHAN FM, KOMARLA AR, MENDOZA PG, et al.Keratin19demonstration of canal of Hering loss in primary biliary cirrhosis:“minimal change PBC”[J].Hepatology, 2013, 57 (2) :700-707. [15]MOREIRA RK, REVETTA F, KOEHLER E, et al.Diagnostic utility of Ig G and Ig M immunohistochemistry in autoimmune liver disease[J].World J Gastroenterol, 2010, 16 (4) :453-457. [16]SHEN B, ZHOU XG.Detection of Ig M and Ig G in plasma cells of liver biopsy specimens from primary biliary cirrhosis and autoimmune hepatitis by immunohistochemistry[J].Chin J Gastroenterol Hepatol, 2010, 19 (10) :901-904. (in Chinese) 沈冰, 周新刚.原发性胆汁性肝硬化和自身免疫性肝炎肝组织中浆细胞Ig M和Ig G的免疫组化检测[J].胃肠病学和肝病学杂志, 2010, 19 (10) :901-904. [17]MIAO Q, CHEN XY.Pathological features of autoimmune liver diseases[J].Chin J Gastroenterol, 2018, 23 (5) :287-292. (in Chinese) 苗琪, 陈晓宇.自身免疫性肝病相关病理特征[J].胃肠病学, 2018, 23 (5) :287-292. [18]Chinese Society of Hepatology, Chinese Medical Association;Chinese Society of Gastroenterology, Chinese Medical Association;Chinese Society of Infectious Diseases, Chinese Medical Association.Consensus on the diagnosis and management of primary sclerosing cholangitis (2015) [J].JClin Hepatol, 2016, 32 (1) :23-31. (in Chinese) 中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会.原发性硬化性胆管炎诊断和治疗专家共识 (2015) [J].临床肝胆病杂志, 2016, 32 (1) :23-31.
本文二维码
计量
- 文章访问数: 2583
- HTML全文浏览量: 106
- PDF下载量: 500
- 被引次数: 0