慢性乙型肝炎患者肝组织Toll样受体2、3的表达水平及临床意义

摘要

目的 研究慢性乙型肝炎(CHB)患者肝组织Toll样受体(TLR)2、3的表达变化与肝脏炎症活动度、肝纤维化程度的相关性及其临床意义.方法 收集桂林市第三人民医院肝病科自2013年1月-2016年12月住院且初次诊断为CHB的患者104例,运用1秒钟快速肝穿刺活组织检查方法获取CHB患者的肝组织,分别进行TLR2、TLR3免疫组化染色,10例肝血管瘤者趋于正常的瘤旁肝组织作为对照组.比较两组TLR2、TLR3与肝脏炎症活动度、肝纤维化程度的相关性.等级资料多组间比较采用Kmskal-Wallis H检验,相关性分析采用Spearman相关分析.结果 对照组未见明显的TLR2、TLR3阳性表达;TLR2在CHB患者肝组织中表达较弱,TLR2表达强度与肝组织炎症活动度分级、肝纤维化程度分级无相关性(rs值分别为-0.086和-0.112,P值均＞0.05);TLR3在CHB患者肝组织中表达较强,TLR3的表达强度与肝组织炎症活动度分级呈显著的正相关性(r5=0.528,P＜0.01),亦与肝组织纤维化分级呈显著的正相关性(rs =0.510,P＜0.01).结论 TLR3可能参与了CHB的某些免疫发病机制和肝纤维化的病理过程.%Objective To investigate the correlation of the expression of Toll-like receptor 2 (TLR2) and Toll-like receptor 3 (TLR3) in live tissue with the grade of liver inflammation and degree of liver fibrosis and related clinical significance in patients with chronic hepatitis B (CHB).Methods A total of 104 patients who were hospitalized in Department of Hepatology,The Third People's Hospital of Guilin,from January 2013 to December 2016 and were diagnosed with CHB were enrolled.Liver biopsy was used to obtain liver tissue samples from CHB patients,and immunohistochemical staining of TLR2 and TLR3 was performed.Normal adjacent liver tissue samples collected from 10 patients with hepatic hemangioma were used as controls.The correlation of TLR2 and TLR3 with the grade of liver inflammation and degree of liver fibrosis was analyzed.The Kruskal-Wallis H test was used for comparison between multiple groups,Spearman correlation analysis was used to investigate correlation.Results There was no marked positive expression of TLR2 and TLR3 in the control group.There was weak expression of TLR2 in the liver tissue of CHB patients,and the expression of TLR21 was not correlated with the grade of liver inflammation or the degree of liver fibrosis (rs =-0.086 and-0.112,both P ＞ 0.05).There was strong expression of TLR3 in the liver tissue of CHB patients,and the expression of TLR3 was significantly positively correlated with the grade of liver inflammation (rs =0.528,P ＜ 0.01);TLR3 also had a linear relationship with the grade of liver inflammation (x2 =16.679,P＜0.01).Conclusion TLR3 may be involved in the immune pathogenesis of CHB and the pathological process of liver fibrosis.