Objective To investigate the changes in positive staining of CD34, CK7, and CK19 and amount of fibrous collagen deposition in patients with chronic hepatitis B ( CHB) and the pathological basis affecting FibroTouch measurements. Methods A retrospective analysis was performed for the clinical data of 72 CHB patients who visited Department of Liver Cirrhosis in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2015 to December 2017. The amount of positive immunohistochemical staining of CD34, CK7, and CK19 was calculated, as well as the amount of fibrous collagen deposition in Masson trichrome staining and liver stiffness measurement ( LSM) by FibroTouch. The t-test was used for comparison of normally distributed continuous data between two groups. The Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data or continuous data with heterogeneity of variance between two groups. The chi-square test was used for comparison of categorical data between groups, and the Kruskal-Wallis H test was used for comparison of ranked data between multiple groups. The receiver operating characteristic ( ROC) curve was used to analyze the value of LSM in the diagnosis of hepatitis B cirrhosis, and the logistic regression model was used for multivariate analysis. Results With the increase in inflammation degree, there was no significant change in the amount of positive staining of CD34 ( P > 0. 05) , while there were significant increases in the amount of positive staining of CK19 and the amount of fibrous collagen deposition ( H = 9. 02 and 14. 12, P =0. 011 and 0. 001) . With the progression of liver fibrosis, there were significant increases in the amount of positive staining of CD34 and CK7 and the amount of fibrous collagen deposition ( H = 10. 26, 16. 29, and 22. 97, P = 0. 016, 0. 001, and < 0. 001) . The logistic regression analysis showed that the amount of positive staining of CK7 ( Wald = 4. 756, P = 0. 029) and the amount of fibrous collagen deposition ( Wald = 4. 757, P = 0. 029) were independent influencing factors for FibroTouch measurements. Conclusion Increases in the amount of fibrous collagen deposition and the amount of positive staining of CK7 may lead to increased FibroTouch measurements.
[1]JIN CT, GUO LW, LIANG WF.Research progress on non-invasive serum markers for liver fibrosis assessment in patients with chronic hepatitis B[J/CD].Chin J Exp Clin Infect Dis:E-lectronic Edition, 2018, 12 (1) :11-14. (in Chinese) 金彩婷, 郭利伟, 梁伟峰.慢性乙型病毒性肝炎肝纤维化无创性血清诊断指标研究进展[J/CD].中华实验和临床感染病杂志:电子版, 2018, 12 (1) :11-14.
|
[2]SARIN SK, KUMAR M, LAU GK, et al.Asian-Pacific clinical practice guidelines on the management of hepatitis B:A 2015update[J].Hepatol Int, 2016, 10 (1) :1-98.
|
[3]VIZZUTTI F, ARENA U, ROMANELLI RG, et al.Liver stiffness measurement predicts severe portal hypertension in patients with HCV-related cirrhosis[J].Hepatology, 2007, 45 (5) :1290-1297.
|
[4]de LDINGHEN V, WONG VW, VERGNIOL J, et al.Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement:Comparison between M and XL probe of FibroScan (R) [J].JHepatol, 2012, 56 (4) :833-839.
|
[5]CHON YE, CHOI EH, SONG KJ, et al.Performance of transient elastography for the staging of liver fibrosis in patients with chronic hepatitis B:A meta-analysis[J].PLo S One, 2012, 7 (9) :e44930.
|
[6]Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B:A 2015 update[J].JClin Hepatol, 2015, 31 (12) :1941-1960. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南 (2015年更新版) [J].临床肝胆病杂志, 2015, 31 (12) :1941-1960.
|
[7]WANG TL, LIU X, ZHOU YP, et al.A semiquantitative scoring system for assessment of hepatic inflammation and fibrosis in chronic viral hepatitis[J].Chin J Hepatol, 1998, 6 (4) :5-7. (in Chinese) 王泰龄, 刘霞, 周元平, 等.慢性肝炎炎症活动度及纤维化程度计分方案[J].中华肝脏病杂志, 1998, 6 (4) :5-7.
|
[8]ABDALLA AF, ZALATA KR, ISMAIL AF, et al.Regression of fibrosis in paediatric autoimmune hepatitis:Morphometric assessment of fibrosis versus semiquantiatative methods[J].Fibrogenesis Tissue Repair, 2009, 2 (1) :2.
|
[9]BEDOSSA P.Utility and appropriateness of the fatty liver inhibition of progression (FLIP) algorithm and steatosis, activity, and fibrosis (SAF) score in the evaluation of biopsies of nonalcoholic fatty liver disease[J].Hepatology, 2014, 60 (2) :565-575.
|
[10]STUECK AE, WANLESS IR.Hepatocyte buds derived from progenitor cells repopulate regions of parenchymal extinction in human cirrhosis[J].Hepatology, 2015, 61 (5) :1696-1707.
|
[11]THEISE ND, SAXENA R, PORTMANN BC, et al.The canals of Hering and hepatic stem cells in humans[J].Hepatology, 1999, 30 (6) :1425-1433.
|
[12]ROSKAMS TA, THEISE ND, BALABAUD C, et al.Nomenclature of the finer branches of the biliary tree:Canals, ductules, and ductular reactions in human livers[J].Hepatology, 2004, 39 (6) :1739-1745.
|
[13]LIN WR, LIM SN, MCDONALD SA, et al.The histogenesis of regenerative nodules in human liver cirrhosis[J].Hepatology, 2010, 51 (3) :1017-1026.
|
[14]YOON SM, GERSIMIDOU D, KUWAHARA R, et al.Epithelial cell adhesion molecule (EpCAM) marks hepatocytes newly derived from stem/progenitor cells in humans[J].Hepatology, 2011, 53 (3) :964-973.
|
[15]FALKOWSKI O, AN HJ, IANUS IA, et al.Regeneration of hepatocyte'buds'in cirrhosis from intrabiliary stem cells[J].J Hepatol, 2003, 39 (3) :357-364.
|
[16]GUIDO M, SARCOGNATO S, SONZOGNI A, et al.Obliterative portal venopathy without portal hypertension:An underestimated condition[J].Liver Int, 2016, 36 (3) :454-460.
|
[17]OHBU M, OKUDAIRA M, WATANABE K, et al.Histopathological study of intrahepatic aberrant vessels in cases of noncirrhotic portal hypertension[J].Hepatology, 1994, 20 (2) :302-308.
|
[18]GUIDO M, SARCOGNATO S, RUSSO FP, et al.Focus on histological abnormalities of intrahepatic vasculature in chronic viral hepatitis[J].Liver Int, 2018, 38 (10) :1770-1776.
|
[19]DEFFIEUX T, GENNISSON JL, BOUSQUET L, et al.Investigating liver stiffness and viscosity for fibrosis, steatosis and activity staging using shear wave elastography[J].J Hepatol, 2015, 62 (2) :317-324.
|
[20]CASSINOTTO C, BOURSIER J, LEDINGHEN V, et al.Liver stiffness in nonalcoholic fatty liver disease:A comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy[J].Hepatology, 2016, 63 (3) :1817-1827.
|
[21]SADLER MD, CROTTY P, FATOVICH L, et al.Noninvasive methods, including transient elastography, for the detection of liver disease in adults with cystic fibrosis[J].Can J Gastroenterol Hepatol, 2015, 29 (3) :139-144.
|
[22]RAMZY I, ELSHARKAWY A, FOUAD R, et al.Impact of old Schistosomiasis infection on the use of transient elastography (Fibroscan) for staging of fibrosis in chronic HCV patients[J].Acta Trop, 2017, 176:283-287.
|
[23]LENG XJ, YAN XB.Efficiency of FibroTouch in evaluating liver fibrosis degree in nonalcoholic fatty liver disease patients with different levels of body mass index[J].J Clin Hepatol, 2018, 34 (9) :1891-1895. (in Chinese) 冷雪君, 颜学兵.FibroTouch对不同BMI水平非酒精性脂肪性肝病患者肝纤维化程度的评估比较[J].临床肝胆病杂志, 2018, 34 (9) :1891-1895.
|
[24]LI JB, LIU S, WEN B, et al.Clinical significance of FibroTouch, ultrasound, and computed tomography in diagnosis of fatty liver disease:A comparative analysis[J].J Clin Hepatol, 2016, 32 (3) :459-462. (in Chinese) 李静波, 刘姝, 温博, 等.FibroTouch与B超、CT对脂肪肝的诊断价值比较[J].临床肝胆病杂志, 2016, 32 (3) :459-462.
|
[25]Review Panel for Liver Stiffness Measurement.Recommendations for the clinical application of transient elastography in liver fibrosis assessment[J].Chin J Hepatol, 2013, 21 (6) :420-424. (in Chinese) 肝脏硬度评估小组.瞬时弹性成像技术诊断肝纤维化专家意见[J].中华肝脏病杂志, 2013, 21 (6) :420-424.
|
[26]JIA J, HOU J, DING H, et al.Transient elastography compared to serum markers to predict liver fibrosis in a cohort of Chinese patients with chronic hepatitis B[J].J Gastroenterol Hepatol, 2015, 30 (4) :756-762.
|