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Objective To explore the expression of cyclin D1, p21WAF1, p53 and Ki-67 protein in hepatocellular carcinoma (HCC) and its relationship with prognosis of HCC patients. Methods Liver specimens were collected from 80 HCC patients who received hepatectomy in the General Hospital of PLA from Jan. 2000 to Jan. 2005, and the expressions of cyclin D1, p21WAF1, p53 and Ki-67 protein were determined by immunohistochemical staining (EliVision method) to investigate the relationship between the protein expressions and the clinicopathologic characteristics of HCC, and their relationship with the survival rate of the patients was analyzed. Results The positive expression rates of cyclin D1, p21WAF1, p53 and Ki-67 in HCC were 38.8%, 40.5%, 65.4% and 80.0% respectively, and they were significantly higher than those in matched normal tissues (19.0%, 11.5%, 0.0% and 6.3% respectively, P

Objective To explore epidemiological, serological and histopathological (by liver biopsy) features of liver diseases, and clinical manifestations in patients of the Chinese armed forces. Methods The clinical data of 231 cases of military patients with liver diseases in our hospital were retrospectively analyzed in terms of their age, gender, location of enlistment, services, official rank, clinical manifestation, and laboratory examination, and also pathological characteristics of liver biopsy. Results Among the 231 hospitalized military patients, 202 were male and 29 were female. The age at onset of the disease ranged from 18 to 73 years (mean age 29.7±9.1). Higher morbidity (48.1%) was found in the 18-25 year age bracket, while lower (only about 7.4%) in above 55-year-old age bracket. Virus infection accounted for 68.0% and non-virus infection accounted for 32.0%. About 64.9% of the patients suffered from chronic liver disease, while 35.1% from acute liver disease. In addition, the prevalence of liver disease was as high as 47.2% in the soldiers, slightly higher than that in the officers (about 38.1%). Transmission of the disease between comrades in arms accounted approximately for 14.0%. Conclusions The mean age of onset of liver disease in military personnel is younger, ranging from 18 to 25 years old predominantly, and the incidence is gradually decreased along with the age. The prevalence of liver disease may be higher in soldiers than in officers. There is a higher percentage of virus infection-associated liver ailment and chronic liver ailment. For acute liver ailment, pathological diagnosis by liver biopsy should be made, and timely therapeutic measures should be taken to prevent transformation of acute to chronic stage.

Objective To establish a method of detecting HBV covalently closed circular DNA(cccDNA) in micro-formalin fixed paraffin imbedding(FFPE) liver biopsy samples.Methods FFPE liver biopsies from 37 patients with chronic hepatitis B were studied.The intrahepatic HBV DNA was extracted and pre-treated with plasmid-safe ATP-dependent DNAse(PSAD),and then amplified by rolling circular amplification(RCA).The HBV cccDNA was quantitatively detected by Taqman real-time PCR with primers located on both sides of the gap of HBV DNA.The human β-actin gene served as the internal control.The sensitivity was tested by serially diluting the DNA templates with known concentrations.The repeatability and stability were evaluated with inter-assay and intra-assay.The level of intrahepatic HBV cccDNA,HBV total DNA,serum HBV DNA and ALT were also compared to find the relations between them.Results The quantitative detection method of cccDNA in micro-FFPE liver samples was successfully set up with considerable sensitivity,stability and specificity.The intrahepatic cccDNA level was significantly higher in the HBeAg-positive patients than in the HBeAg-negative patients(P < 0.05).The intrahepatic HBV cccDNA level was positively correlated with the serum and intra-hepatic HBV DNA level(r=0.539,P=0.001).Conclusion The assay established by present study is fit for the detection of HBV cccDNA in micro-FFPE liver biopsies.

Objective To investigate the relationship of the proliferation and activation of immunocytes in gastric mucosa with the disease progression in HIV-infected individuals.Methods Thirty-six HIV-infected individuals,and 10 persons without HIV infection serving as control,were enrolled in present study,and biopsy of gastric mucosal tissues was performed by fiberoptic gastroscopy.Immunohistochemistry(SP) was used to detect the expressions of CD38 and Ki-67 in gastric mucosa.Masson stain was used to observe collagen deposition in gastric mucosa.Results Compared with the non-infected controls,the expression of CD38 remarkably increased in HIV-infected individuals(97.384±11.573 vs 86.215±12.396,P < 0.01),but there was no difference between asymptomatic HIV carriers and AIDS patients(82.954±10.725,79.982±12.443,P > 0.05).In HIV-infected individuals,Ki-67 positive cells were mainly located in gastric foveola,lamina propria gland and stroma.As compared with the non-infected controls,Ki-67 positive immunocytes were remarkably decreased in stroma(20.933±2.719 vs 29.091±21.949,P < 0.01),but there was also no significant difference between asymptomatic HIV carriers and AIDS patients(27.985±4.650,29.328±7.343,P > 0.05).The Ki-67 positive cells were mostly lymphocytes in the lymphoid follicle of gastric mucosa in asymptomatic HIV carriers,while connective tissue cells such as fibroblasts were predominant in AIDS patients.There was more abundant collagen deposition in stroma and lymphatic follicles in AIDS patients than in asymptomatic HIV carriers.In AIDS patients,the follicle fibrous septum was found to be increased and widened in some region.Conclusion After HIV infection,the disequilibrium of activation and proliferation of immunocytes,as well as collagen deposition in mucosa,are probably the main pathogenetic factors of AIDS.

Objective To investigate the clinical and pathological characteristics of hemochromatosis(HC),and provide references for HC diagnosis and treatment.Methods Liver specimens were obtained via needle biopsy from 20 cases of HC.Histological specimens were stained with haematoxylin eosin.Pathological changes of liver tissues were analyzed together with the clinical data.Results Ten cases of hereditary hemochromatosis(HHC) and 10 cases of secondary hemochromatosis(SHC) were randomly selected.Fatigue(18/20),hepatomegalia(18/20) and splenomegalia(17/20)were the common clinical manifestations.The 20 HC cases characterized by iron overload and fibrosis may be divided into HHC type(17 cases) and non-HHC type(3 cases) according to the region of iron deposition.All the 10 cases of HHC showed HHC type,while 7 of the 10 SHC cases showed HHC type,and the other 3 SHC cases showed non-HHC type.Steatosis,eosinophile granulocyte infiltration and vacuolus nucleus were also observed frequently in the liver tissues of HC,and their distribution coincided with the region of iron deposition.Statistically,fibrosis was significantly associated with iron deposition and serum iron in HHC patients(P < 0.05),but not associated with steatosis and duration of HHC.Additionally,fibrosis was not associated with iron deposition,serum iron,steatosis and duration of SHC in SHC patients.Conclusions The final diagnosis of HC depends mainly on histological changes in liver tissues.Meanwhile,it is necessary to distinguish HHC from SHC according to case history and biochemical detection.HHC might be a metabolic disease with multi-organ damage due to the disruption of homeostasis by iron overload.To avoid multi-organ failure,patients with HHC should be diagnosed and treated as early as possible.

Objective To explore the clinical and pathological features of congenital hepatic fibrosis with Caroli’s disease.Methods The clinical characteristics of 6 patients with congenital hepatic fibrosis and Caroli’s disease were analyzed,and the histological features of hepatic tissue were observed by using hematoxylin and eosin staining and histochemical staining.Results The mean age of the 6 patients was 7.8 years,and the sex ratio(male to female) was 2:4.The main clinical manifestations were hematemesis(5/6),hypodynamia(5/6) and hepatosplenomegaly(5/6).Three of the 6 patients were complicated with portal hypertension,2 cases complicated with diffuse parenchyma lesion in the double kidneys,and 1 case showed abnormal hepatic function.The main histological features were fibrosis of periportal area,epithelial tissue proliferation of interfibrous bile ducts,capsular ectasia of intrahepatic bile ducts,cholestasis and inflammatory infiltration.Pseudolobule formation in hepatic tissue may observed,but most of the hepatic plates arranged still in order.Conclusions Congenital hepatic fibrosis with Caroli’s disease is presented in adolescent.The diagnosis of the disease is mainly based on periportal fibrosis and capsular ectasia of intrahepatic bile ducts combined with clinical data.

Objective To investigate the clinical and pathological characteristics of vanishing bile duct syndrome(VBDS),and provide references for clinical diagnosis.Methods Twenty four children with VBDS diagnosed by liver biopsy were collected in 302 Hospital of PLA from 2007 to 2009.Liver tissues were stained with haematoxylin eosin staining.The clinical and pathological characteristics were analyzed.Results The mean age of all patients(mean SD) was 4.08±3.11 years and the sex ratio(male to female) was 2.4:1.The most common symptoms were jaundice and pruritus in 24 children with VBDS.The mean levels of ALT,AST,ALP,GGT and TBil were 203.45 239.42U/L,238.54 224.11U/L,524.04 300.96U/L,242.17 220.86U/L and 242.17 220.86 μmol/L,respectively.Nineteen of 24 cases were positive for anti-CMV IgM,anti-CMV IgG or CMV PP65.Five cases were undergone the operation of biliary atresia.The main pathological characteristic of VBDS was atresia or disappearance of interlobular bile ducts to various degrees.Moreover,histological changes varied with respect to different causes.Obvious inflammatory infiltration in the portal tracts and hepatocytes damage were more common in VBDS caused by cytomegalovirus(CMV) infection.Conclusions The incidence of VBDS is higher in boys than in girls.CMV infection plays an important role in the progress of VBDS.Different pathological characteristics may exist in VBDS caused by different etiological factors.

Objective To explore the histological morphous,immunohistochemical and clinical features,differential diagnosis and prognosis of hepatic inflammatory angiomyolipoma(AML).Methods The clinical and pathological data of 5 patients with inflammatory hepatic AML were retrospectively analyzed followed by follow-up.The typical tissue was observed by immunohistochemical staining.Results Five patients(1 male and 4 females) aged from 21 to 48 years.Tumors were situated in left lobe of liver in 3 patients,and in right lobe in 2 patients.The tumors had a diameter of 5.5-10.0cm averaged 7.5cm.Generally,the tumors were grey-white on cut surface,without hemorrhage,necrosis and cystic degeneration.Microscopically,the tumors were consisted of spindle and epithelioid myocytes,irregular thick-walled blood vessels and adipose tissue in different proportion.A prominent infiltration of inflammatory cells,including lymphocytes,plasmocytes and histiocytes,in the background was noted in all cases.No obvious atypia and mitotic figure,and no hemorrhage,necrosis and cystic degeneration were noted in the tumor cells.It was immunohistochemically revealed that the tumor cells of all the 5 patients were positive in HMB-45,Melan-A,SMA and Vimentin,while negative in CD21,CD35,CK18,CK19,hepatocyte paraffin-1,AFP,EMA and CK.All the patients were undergone local hepatectomy without recurrence during a 3 to 9 years follow-up.Conclusion Inflammatory hepatic AML is one of the sub-types of AML,demonstrating a similar benign biologic behavior with classical AML.

Objective To study the clinical and pathological characteristics of Gaucher’s disease.Methods The clinical data of three patients with Gaucher’s disease were analyzed.The pathological morphology of Gaucher’s disease was observed under microscopy and double immunohistochemical staining was performed.Results All the 3 cases of Gaucher’s disease(including two females and one male) were diagnosed by liver biopsy.Their age of onset was 11,19 and 23 years old,respectively,with an average of 17.6 years old.The duration was 1-7 years.All the 3 patients were weak when they were young.The early symptoms of disease were anaemia,decreased blood platelet,hepatosplenomegaly,and portal hypertension or sinusoidal obstruction syndrome.Histologically,clusters of Gaucher cells with augmented volume were observed in expanded hepatic sinusoid of peripheral central veins and the cytoplasm of Gaucher cells were fibriform or crinkled.Immunohistochemistry revealed strongly positive expression of CD68 in liver tissue of the 3 cases,which was further demonstrated by double staining of CD68 and Hepa.No obvious diffuse hydropic degeneration of hepatocytes,focal inflammation or sinus inflammation was found.One case of Gaucher’s disease showed significant enlargement of portal area.The proliferative fibrous tissue was old and compact,which resulted in distortion of lobules and the formation of pseudolobule.Conclusions The 3 cases involved in present study show an earlier age of onset.They may have early changes of cirrhosis but the percentage of correct diagnosis is very low for the clinical characteristics lacked.Liver biopsy plays a very important role in the diagnosis of Gaucher’s disease.