Histological difference between complete responders and non-responders to interferon therapy of the livers of patients with chronic hepatitis C.

T Uchida, M Taira, T Shikata, M Moriyama, N Tanaka, H Okubo, Y Arakawa
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引用次数: 17

Abstract

Liver histology was compared in patients with chronic hepatitis C to note the differences between responders and non-responders to interferon treatment. Fifty-eight patients were administered interferon in varying doses and over various periods, and were then followed up for 1 year. According to the improvement status of serum alanine aminotransferase (ALT) levels during this period, the patients were classified into complete responders who showed complete normalization of ALT; partial responders who exhibited a significant decrease, but not complete normalization of ALT; and non-responders who did not reveal any significant decrease of ALT. Before application of the interferon treatment, liver biopsies were analyzed in four parameters and given scores from 0 to 5 for three groups in cord with no prior knowledge of the efficacy. The parameters included necroinflammation, fibrosis/lobular distortion, portal lymphocytic reaction and portal (or fibrous septal) outline destruction. Results indicated that there were no significant differences in the score of necroinflammation and portal lymphocytic reaction between the complete responder group and the non-responder group. In contrast, the complete responder group exhibited weaker fibrosis/lobular distortion and less portal outline destruction than the non-responder group. The partial responder group was more akin to the former group in these parameters. Thus, it is safe to conclude that liver histology may predict the efficacy of interferon treatment.

慢性丙型肝炎患者肝脏干扰素治疗完全应答者与无应答者的组织学差异
比较慢性丙型肝炎患者的肝脏组织学,以注意干扰素治疗反应者和无反应者之间的差异。58例患者接受不同剂量、不同时期的干扰素治疗,随访1年。根据这段时间内血清丙氨酸转氨酶(ALT)水平的改善情况,将患者分为ALT完全恢复正常的完全缓解者;部分应答者表现出ALT显著下降,但未完全正常化;在应用干扰素治疗之前,肝活检在四个参数中进行分析,并对三组事先不知道疗效的患者给予0到5分的评分。参数包括坏死炎症、纤维化/小叶扭曲、门静脉淋巴细胞反应和门静脉(或纤维间隔)轮廓破坏。结果显示,完全缓解组和无缓解组在坏死性炎症和门淋巴细胞反应评分上无显著差异。相反,完全反应组比无反应组表现出较弱的纤维化/小叶扭曲和较少的门脉轮廓破坏。部分反应组在这些参数上与前一组更相似。因此,肝脏组织学可以预测干扰素治疗的疗效。
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