原发性胆汁性胆管炎的病理学分期系统

宋欣航; 于涓翰; 程肇平; 邵晨; 邓宝成

doi:10.3969/j.issn.1001-5256.2022.03.033

原发性胆汁性胆管炎的病理学分期系统

DOI: 10.3969/j.issn.1001-5256.2022.03.033

宋欣航¹,
于涓翰²,
程肇平³,
邵晨^4, , ,,
邓宝成^1, , ,

1.
中国医科大学附属第一医院传染科，沈阳 110000
2.
中国医科大学基础医学院病理教研室，沈阳 110000
3.
安康市中心医院病理科，陕西安康 725000
4.
首都医科大学附属北京佑安医院病理科，北京 100069

基金项目:

辽宁省科学技术计划 (2019JH2/10300031);

国家“十三五”科技重大专项 (2017ZX10103007)

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：宋欣航负责资料分析，撰写论文；于涓翰、程肇平参与收集数据，修改论文；邓宝成、邵晨负责设计，拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
邵晨，shaochen83@126.com

邓宝成，sydengbc@163.com

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出版历程
- 收稿日期: 2021-07-11
- 录用日期: 2021-08-16
- 出版日期: 2022-03-20

Pathological staging systems of primary biliary cholangitis

1.
Department of Infectious Diseases, The First Affiliated Hospital of China Medical University, Shenyang 110000, China
2.
Department of Pathology, School of Basic Medical Sciences, China Medical University, Shenyang 110000, China
3.
Department of Pathology, Ankang Central Hospital, Ankang, Shaanxi 725000, China
4.
Department of Pathology, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China

Research funding:

Liaoning Provincial Science and Technology Project (2019JH2/10300031);

National Science and Technology Major Project during the 13th Five-Year Plan Period (2017ZX10103007)

More Information

Corresponding author: SHAO Chen, shaochen83@126.com(ORCID:0000-0002-7914-5493); DENG Baocheng, sydengbc@163.com(ORCID:0000-0003-4825-9794)

摘要

摘要: 原发性胆汁性胆管炎(PBC)是一种伴有胆汁淤积的慢性自身免疫性肝脏疾病，其组织学特征为非化脓性胆管炎。本文简述了传统的PBC病理分期系统如Rubin分期、Scheuer分期以及Ludwig分期和最新的Nakanuma分期各自的优点和局限性，其中Nakanuma分期细化了组织学分级分期标准，减少因采样误差而漏诊的机会，从而为临床提供更充分的诊断及预后信息。新旧分期系统结合应用更有利于指导PBC的诊治和相关研究。
- 原发性胆汁性胆管炎 /
- 病理学 /
- 分期
Abstract: Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease accompanied by cholestasis, with the histological feature of non-purulent cholangitis. This article briefly describes the advantages and limitations of the traditional pathological staging systems such as Rubin stage, Scheuer stage, and Ludwig stage and the latest Nakanuma stage. Among them, Nakanuma stage refines the histological grading and staging standards to reduce the chance of missed diagnosis due to sampling errors, thus providing more adequate diagnostic and prognostic information for the clinic. A combination of new and traditional staging systems can provide guidance to the diagnosis, treatment, and research of PBC.
- Primary Biliary Cholangitis /
- Pathology /
- Stage

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表 1 Nakanuma评分

项目	病理表现
纤维化评分
0分	无纤维化，或纤维化局限于汇管区
1分	汇管区纤维化伴汇管区周围纤维化或不完全纤维间隔
2分	桥接纤维化伴小叶紊乱
3分	肝硬化伴再生结节和广泛纤维化
胆管缺失评分
0分	无胆管缺失
1分	＜1/3的汇管区有胆管缺失
2分	1/3~2/3的汇管区有胆管缺失
3分	＞2/3的汇管区有胆管缺失
地衣红阳性颗粒的沉积评分
0分	无地衣红阳性颗粒沉积
1分	＜1/3的汇管区周围肝细胞有颗粒沉积
2分	1/3~2/3的汇管区周围肝细胞有颗粒沉积
3分	＞2/3的汇管区周围肝细胞有颗粒沉积

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