摘要
目的探讨免疫检查点抑制剂诱导性药物性肝损伤(immune checkpoint inhibitors induced liver injury,ICIs-DILI)的组织病理学特点。方法对3份ICIs-DILI肝组织标本进行常规HE、罗丹宁法铜染色、普鲁士蓝法铁染色、及CD3、CD20、mum-1、CK19等免疫组化染色,观察ICIs-DILI的组织病理学改变。结果3份肝组织均显示不同程度的淤胆、毛细胆管胆栓形成及肝细胞坏死,小叶内可见微小肉芽肿,小叶间胆管呈损伤性改变伴细胆管反应,汇管区轻-中度混合炎细胞浸润,可见浆细胞。结论ICIs-DILI的肝细胞和胆管细胞均受累及。
Objective To explore the histopathological characteristics of immune checkpoint inhibitor-induced liver injury(ICIs-DILI).Methods Three liver biopsy specimens of ICIs-DILI were stained with Hematoxylin eosin staining Rhodanine copper staining,Prussian blue iron staining,CD3,CD20,mum-1 and CK19 immunohistochemical staining,and the histopathological changes of ICIs-DILI were observed.Results All three cases showed cholestasis,bile thrombosis of canalicular cholestasis and hepatocyte necrosis in different degrees.Microgranuloma was found in lobules,interlobular bile duct was damaged with bile ductular reaction,and light-to-moderate mixed inflammatory cells infiltrated in portal area,and plasma cells were seen.Conclusion Liver histopathology of ICIs-DILI has its relative pathological characteristics,both hepatocytes and epithelial cells of bile duct are involved,especially the bile duct injury deserves clinical attention.The definite diagnosis of ICIs-DILI should be combined with clinic and pathology.
作者
郭林林
常静
周光德
Guo Linlin;Chang Jing;Zhou Guangde(Department of Pathology,Beijing You’an Hospital,Capital Medical University,Beijing 100069,China)
出处
《肝脏》
2025年第4期529-531,547,共4页
Chinese Hepatology
基金
国家重点研发计划课题(2023YFC2308101)。
