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目的研究程序性死亡因子-1(programmed death1,PD-1)与慢性乙型病毒性肝炎病理的相关性,探讨PD-1在慢性HBV感染病情进展中的作用。方法对84例慢性乙型病毒性肝炎患者行肝组织活检,肝组织标本经10%福尔马林液固定、石蜡包埋切片后,以HE染色评判肝组织炎症活动度(G)和肝纤维化程度(S)。采用免疫组织化学染色SP法检测肝组织中PD-1的表达,以红色为阳性表达区域,每张切片在高倍镜下(400×)选取5个不连续视野进行图像采集,采用Image-Pro Plus6.0图像分析系统进行测量分析,以积分光密度(integral optical density,IOD)值表示PD-1在肝组织中的表达水平。结果 PD-1表达强度与肝组织炎症活动度及纤维化程度均呈正相关,相关系数分别为0.898(P<0.001)、0.700(P<0.001)。肝组织炎症活动度G0～G4级组间,PD-1的表达差异均有统计学意义(P<0.05)。肝组织纤维化S2期与S3期、S3期与S4期间PD-1的表达,差异无统计学意义(P>0.05),其余各纤维化分期之间PD-1的表达,差异均有统计学意义(P<0.05)。结论肝组织内的PD-1表达水平与CHB患者肝脏炎症及纤维化发生、进展呈正相关。测定PD-1的IOD值有助于辅助评判肝组织炎症活动度及肝纤维化程度,可以作为评判肝炎病理情况的参考指标。
Objective To investigate the relationship between programmed death 1 (PD-1) and pathology of chronic hepatitis B and to explore the role of PD-1 in the progression of chronic HBV infection. Methods Totally 84 patients with chronic hepatitis B were examined for liver biopsy. The liver tissue samples were fixed in 10% formalin solution and paraffin embedded sections were used to evaluate the liver inflammation activity (G) and liver fibrosis Degree of (S). The expression of PD-1 in hepatic tissue was detected by immunohistochemical SP method. The positive area of red staining was detected. Each section was taken at a magnification (400 ×) of 5 discontinuous fields for image acquisition. Image-Pro Plus6 .0 image analysis system for measurement and analysis, the integrated optical density (integral optical density, IOD) value that PD-1 in liver tissue expression level. Results The expression of PD-1 was positively correlated with the degree of inflammation and the degree of fibrosis. The correlation coefficients were 0.898 (P <0.001) and 0.700 (P <0.001), respectively. There was significant difference in the expression of PD-1 between G0 ~ G4 group in inflammatory activity of liver tissue (P <0.05). There was no significant difference in the expression of PD-1 between stage S2 and S3, between S3 and S4 in liver fibrosis (P> 0.05), and there was statistical difference in the expression of PD-1 among other fibrosis stages Significance (P <0.05). Conclusion The expression of PD-1 in liver tissue is positively correlated with the occurrence and progress of hepatic inflammation and fibrosis in CHB patients. Determining the IOD value of PD-1 is helpful to assess the degree of liver inflammation and liver fibrosis, which can be used as a reference index to judge the pathological condition of hepatitis.