Dergiler / Turkish Journal of Gastroenterology / 2003 / Cilt: 14 - Sayı: 4
A comparative immunohistochemical study of HBsAg, HBcAg and CD57 in chronic hepatitis B pediatric patients and without malignant disorders
- Sayfa
- 234–238
- DOI
- —
Özet
Amaç: Bu çalişmada 73 pediatrik kronik hepatit B olgusunun karaciğer biyopsilerinde histopatolojik değişiklikler, hepatit B yüzey antijeni (HBsAg), hepatit B kor antijeni (HBcAg) ve CD57 pozitif lenfosit varligi arastirilmistir. Olgularin 27'sinde ayni zamanda lösemi I lenf oma yada malign solid tümör mevcuttur. Çalismanin amaci onkolojik hastaligi olan ve olmayan gruptaki farklari irdelemektir. Yöntem: Karaciğer biyopsilerinde HBsAg, HBcAg ve CD57 antijenleri immünohistokimyasal olarak arastirilmistir. Ayrica histopatolojik olarak incelenen biyopsilerdeki karaciğer hasari Knodell sistemine göre skorlanmis ve tüm bulgular istatistiksel olarak karsilastirilmistir. Bulgular: 43 olguda minimal (%58.9), 27 olguda hafif (%37), 3 olguda (%4.1) orta şiddette kronik hepatit saptanmistir. Fibrozis 4 olguda (%5.5) mevcuttur. Histolojik aktivite endeksi (HAI) açisindan onkolojik hastalar ile diğer grup arasinda istatistiksel fark saptanmamistir. Sirasiyla HBcAg ve HBsAg ekspresyonu orani % 69.9 ve % 90.4 bulunmuştur. 32 olguda (%43.8) CD57 (+) lenfositler mevcuttur. Onkolojik hastalarda HBcAg ekspresyonu diğerlerinden yüksektir. Pearson analizinde HAI ile CD57 (+) lenfosit orani arasinda pozitif; HAI ile HBsAg ekspresyonu arasinda negatif korelasyon saptanmistir. Sonuç: Çalismadan elde edilen sonuçlar onkolojik hastalarda gelişen kronik hepatitlerin tani ve izleminde HbsAg yerine nükleer HBcAg'nin arastirilmasinin daha yararli labileceğini düşündürmektedir.
Abstract
Background/aims: We studied the tissue expression of hepatitis B surface antigen (HBsAg) and hepatitis B core antigen (HBcAg), as well as the presence of CD57 (+) lymphocytes in liver biopsies of 73 chronic hepatitis B pediatric patients. Twenty-seven of them had a malignant disease, either leukemia or solid tumor. We investigated the differences between the oncological and non-oncological patient groups. Methods: Liver biopsy specimens were examined for HBsAg, HBcAg and CD57 antigens immunohistochemically. Liver damage was measured according to the Knodell scoring system and all findings were assessed by Pearson correlation statistical analysis. Results: Forty-three cases (58.9%) had minimal hepatitis, 27 cases (37%) had mild and three cases (4.1%) had moderate hepatitis. Fibrosis was shown in four cases (5.5%). For histological activity index (HAI), there was no statistical difference between the two groups. HBcAg and HBsAg expression rates were 69.9% and 90.4%, respectively. CD57 (+) lymphocytes were found in 32 cases (43.8%). HBcAg expression was higher in oncological patients. There was a positive correlation between HAI and percentage of CD57 (+) cells. However, HBsAg expression showed a negative correlation with HAI. The number of CD57 (+) cells was lower than expected. Conclusion: These results suggest that determination of nuclear HBcAg expression would be more useful in the follow-up of oncological patients with chronic hepatitis B.