Hepatic Histopathology Among Excessive Drinkers Without Advanced Liver Disease.
Hepatic Histopathology Among Excessive Drinkers Without Advanced Liver Disease.
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无晚期肝病的过量饮酒者的肝脏组织病理学。
DOI：
10.1093/alcalc/agab017
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Liangpunsakul,Suthat
中科院分区：
文献类型：
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作者：
Chang,Binxia;Huang,Ang;Saxena,Romil;Sun,Yin;Liu,Shuhong;Zhou,Guangde;Li,Baosen;Teng,Guangju;Zhao,Jun;Zhang,Wei;Jiang,Yanchao;Han,Sen;Yang,Zhihong;Zhao,Jingmin;Zou,Zhengsheng;Liangpunsakul,Suthat
目的酒精相关性肝病代表了从脂肪变性到晚期纤维化和肝硬变的一系列组织病理学变化。方法对62例血清天冬氨酸氨基转移酶正常和83例血清天冬氨酸氨基转移酶正常和83例血清天冬氨酸氨基转移酶正常和异常的酗酒患者的肝脏组织学进行回顾性研究。结果天冬氨酸氨基转移酶(≤)阳性的62例患者中，37%有脂肪变性的组织学改变。其中，我们发现了肝细胞膨胀(21%)、小叶炎症(50%)、门脉炎症(52%)和纤维化(14%)的证据。在AST50U/L组中，29%的患者出现肝脏脂肪变性，60%的患者出现小叶炎症，69%的患者出现门脉炎症。肝纤维化发生率为33%，其中4例为桥接性肝纤维化，1例为肝硬变。我们观察到CD68+巨噬细胞的聚集，而不是呈正态分布，中性粒细胞浸润最少。结论转氨酶活性正常的过量饮酒者肝组织病理改变异常。需要进一步的研究来确定诊断模式，以发现这种异常，并更好地了解其临床意义和长期结果。
AimsAlcohol-associated liver disease represents a spectrum of histopathological changes from steatosis to advanced fibrosis and cirrhosis. The major goals of this retrospective study were to characterize the histologic features in patients with excessive alcohol use who presented with an abnormal hepatic panel and/or abnormal radiographic imaging and did not meet the clinical diagnosis of alcoholic hepatitis or cirrhosis.MethodsWe performed a retrospective study to describe hepatic histology of 62 and 83 excessive drinkers with normal and abnormal serum aspartate transaminase, respectively. The types of inflammatory cells in the liver were characterized by immunohistochemistry for CD4, CD8, CD20, CD68 and myeloperoxidase.ResultsAmong 62 patients with aspartate aminotransferase (AST) ≤ 50 U/L, 37% had histological evidence of steatosis. Of these, we found evidence of hepatocyte ballooning (21%), lobular inflammation (50%), portal inflammation (52%) and fibrosis (14%). For those with AST > 50 U/L, the presence of hepatic steatosis, lobular inflammation and portal inflammation was observed in 29, 60 and 69% of patients, respectively. Fibrosis was found in 33%, four with bridging fibrosis, and one with cirrhosis. We observed the aggregation of CD68+macrophages, rather than normally distributed with minimal neutrophilic infiltration. Lobular and portal lymphocytic infiltrations are primarily CD8+T cells.ConclusionAbnormal hepatic histopathology occurs in excessive drinkers with normal transaminase activity. Future studies to determine the diagnostic modalities to detect such abnormalities and to better understand its clinical implications and long-term outcome are needed.