PATHOLOGICAL DIAGNOSIS OF CHRONIC HEPATITIS-C - A MULTICENTER COMPARATIVE-STUDY WITH CHRONIC HEPATITIS-B
PATHOLOGICAL DIAGNOSIS OF CHRONIC HEPATITIS-C - A MULTICENTER COMPARATIVE-STUDY WITH CHRONIC HEPATITIS-B
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DOI：
10.1016/0016-5085(93)90432-c
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发表时间：
1993-02-01
期刊：
影响因子：
29.4
通讯作者：
VAUGHAN, RD
中科院分区：
文献类型：
--
作者：
LEFKOWITCH, JH;SCHIFF, ER;VAUGHAN, RD
背景：丙型肝炎病毒（HCV）感染中描述的肝脏组织学反应包括胆管损伤、淋巴滤泡和/或汇管中的聚集、大滴和小滴脂肪、肝细胞中的马洛里体样物质、肝细胞发育不良和多核以及肝窦炎症细胞的激活。这些病变对 HCV 感染的特异性尚不确定。方法：在重组干扰素α治疗慢性丙型肝炎和乙型肝炎的两项多中心试验中，检查了治疗前和治疗后肝活检标本中这八个病变的频率，以确定区分 HCV 和乙型肝炎病毒 (HBV) 感染的一组特征（如果有）。对 317 份 HCV 活检标本和 299 份 HBV 标本中的病变进行评分。 结果：逐步逻辑回归确定了一组在 HCV 中比在 HBV 感染中更可能出现的三个特征：胆管损伤 [比值比 (OR)，4.7；比值比 (OR)，4.7； 95% 置信区间 (CI)，1.8–12.3]、淋巴滤泡和/或聚集体（OR，2.4；95% CI，1.2–4.7）和大液滴脂肪（OR，2.4；95% CI，1.4–4.1）。第四个病变，马洛里体样物质，仅在 HCV 活检标本中可见（OR，71.6；95% CI，4.4-996.1）。结论：这四种组织学病变是诊断 HCV 引起的肝脏疾病的有用病理参数。
Background:Hepatic histological responses described in hepatitis C virus (HCV) infection include bile duct damage, lymphoid follicles and/or aggregates in portal tracts, large- and small-droplet fat, Mallory body-like material in hepatocytes, liver cell dysplasia and multinucleation, and activation of sinusoidal inflammatory cells. The specificity of these lesions for HCV infection is uncertain.Methods:In two multicenter trials of recombinant interferon alfa therapy for chronic hepatitis C and B, the frequency of these eight lesions in pretherapy and posttherapy liver biopsy specimens was examined to determine the set of features, if any, that distinguishes HCV from hepatitis B virus (HBV) infection. The lesions were scored in 317 HCV biopsy specimens and 299 HBV specimens.Results:Stepwise logistic regression determined a set of three features more likely to be seen in HCV than in HBV infection: bile duct damage [odds ratio (OR), 4.7; 95% confidence interval (CI), 1.8–12.3], lymphoid follicles and/or aggregates (OR, 2.4; 95% CI, 1.2–4.7), and large-droplet fat (OR, 2.4; 95% CI, 1.4–4.1). A fourth lesion, Mallory body-like material, was seen only in HCV biopsy specimens (OR, 71.6; 95% CI, 4.4–996.1).Conclusions:These four histological lesions are useful pathological parameters in the diagnosis of liver disease caused by HCV.