细胞毒性T细胞穿入现象在原发性胆汁性胆管炎中的表现及意义  

Explore the features and significance of cytotoxic T lymphocytes emperipolesis in primary biliary cholangitis

作　　者：卞兆连[1] 陈琳[1] 居林玲 苗琪[2] 马雄[2] 邵建国[1] 管海涛[1] BIAN Zhaolian CHEN Lin JU Linlin MIAO Qi MA Xiong SHAO Jianguo GUAN Haitao(Nantong Third People＇ s Hospital, Nantong Institute of Liver Disease, Jiangsu 226006 Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Institute of Digestive Disease)

机构地区：[1]南通市第三人民医院,南通市肝病研究所,江苏226006 [2]上海交通大学医学院附属仁济医院消化内科,上海市消化疾病研究所

出　　处：《交通医学》2016年第4期307-310,共4页Medical Journal of Communications

基　　金：南通市科技局资助项目(MS22015105,HS2014061,BK2014073);江苏省科技厅资助项目(BK2016420)

摘　　要：目的:研究原发性胆汁性胆管炎(primary biliary cholangitis,PBC)中发生CD8+细胞毒性T细胞(cytotoxic T lymphocyte,CTL)穿入现象及其意义。方法:收集53例PBC患者肝穿刺标本,采用H&E染色和免疫荧光染色方法,在光学显微镜和激光共聚焦显微镜下观察PBC肝组织中CTL的穿入及穿入宿主细胞的类型,并分析与病程的关系。结果:53例PBC患者中10例(18.9%)发生淋巴细胞穿入肝细胞,15例(28.3%)发生淋巴细胞穿入胆管上皮,仅1例患者同时存在淋巴细胞穿入肝细胞和胆管上皮细胞。免疫荧光染色证实穿入的淋巴细胞是CD8阳性细胞毒性T细胞(CTL)。早期PBC患者中4例(22.2%)、晚期PBC患者中6例(17.1%)发生CTL穿入肝细胞,两组差异无统计学意义(P>0.05)。早期PBC患者中9例(50.0%)、晚期PBC患者中6例(17.1%)发生CTL穿入胆管上皮,两组差异有统计学意义(Z=2.52,P<0.05)。结论:在PBC肝组织中,CTL可穿入肝细胞和胆管上皮细胞,CTL穿入胆管上皮细胞并导致其发生凋亡可能是PBC发病过程中胆管损伤的机制之一。Objective：To explore the features of CD8 positive cytotoxic T lymphocytes （CTL） emperipolesis and its correlation with course of disease in primary biliary eholangitis （PBC）. Methods：H＆E staining was used to determine the phenotype of emperipolesis in PBC. In immunofluorescence, CK8/18 was the marker of hepatoeytes, while CK7 was used to mark cholangiocyte, and CD8 was the marker of CTL; Phenotypes of emperipolesis were observed under optical and laser confocal microscopes; And analyzed the correlation between emperipolesis and disease progression. Results ：Two kinds of emperipolesis were observed in PBC, one is ＇CTL into hepatocyte＇, another is ＇CTL into cholangioeyte＇. Negative correla- tion between ＇CTL into cholangiocyte＇ and course of disease was found. ＇CTL entry into cholangiocyte＇ lead to apoptosis of cholangioeyte. Conclusion：Both ＇CTL into hepatocyte＇ and ＇CTL into cholangiocyte＇were observed in PBC, and apop- tosis of cholangiocyte induced by ＇ CTL into cholangiocyte＇ may be a mechanism of bile duct damage in PBC.

关 键 词：穿入现象 原发性胆汁性胆管炎 胆管上皮 

分 类 号：R575.7[医药卫生—消化系统]