DBPapers
DOI: 10.5593/SGEM2016/B61/S25.062

CLINICAL, HISTOLOGICAL, IMMUNOHISTOCHEMICAL AND MORPHOMETRIC ASPECTS IN PATIENTS WITH CHRONIC HEPATITIS OF ALCOHOLIC AND VIRAL ETIOLOGY

M.Fortofoiu, M.C. Fortofoiu
Wednesday 7 September 2016 by Libadmin2016

References: 16th International Multidisciplinary Scientific GeoConference SGEM 2016, www.sgem.org, SGEM2016 Conference Proceedings, ISBN 978-619-7105-68-1 / ISSN 1314-2704, June 28 - July 6, 2016, Book6 Vol. 1, 471-478 pp

ABSTRACT

Introduction: Hepatology is a constantly changing and developing medical field that will raise the interest of at least a few decades more. Viral hepatitis is a global health problem, that is why updated information is particularly important for doctors, researchers, patients and the public health worldwide. Alcoholic liver disease is also a major public health problem, accounting for 40% of deaths from cirrhosis and more than 30% of hepatocellular carcinoma cases in the United States. Comparable statistics were also reported in Europe.
Objective: Starting from the above-mentioned, we conducted this study on human liver
tissue collected by necropsy and by liver biopsies to see if there are relationships between demographic, clinical and laboratory parameters of patients with chronic liver disease and histological changes induced by viruses known to infect liver or by alcohol. Morphometric study aimed to quantify the area and diameter of adipocytes and liver steatosis and fibrosis.
Patients and Methods: The bioptic material was collected by liver biopsy from patients
with chronic viral and alcoholic liver diseases hospitalized and by necropsy from the liver of patients who died due to complications of chronic alcoholic and/or viral hepatitis or due to other causes. Histological preparation of samples was due by parafin inclusion and stained with hematoxylin-eosin, Goldner-Szekelly green light and Gömöri. The material for morphometric study was processed through the avidin-biotin complex (ABC)/Horse Radish Peroxidase (HRP) method. Immunohistochemical markers used were: vimentin, CD34, CD31, AE1/AE3, S100 protein, collagen III, collagen IV. Histopathological and immunohistochemical preparations were examined by electronic microscope and then were taken with digital video camera attached to the microscope and acquired in computer.
Results: From the 150 cases studied, 48 had ethanolic etiology and 102 cases had viral etiology. Through the serological diagnosis was found that in 47 cases the diagnosis of chronic hepatitis of viral C etiology was sustained and in 55 cases the diagnosis of chronic hepatitis of viral B etiology. Morphometry was used to assess the area and adipocyte diameter, on the microscopic samples with steatosis, on sections stained with HE. After analyzing of the morphological changes, liver steatosis was visualized under three forms: microvesicular, macrovesicular and mixed. Morphometric analysis allowed to determine the size of lipid vacuoles. Significant correlations between the histologic and etiologic type of hepatitis and demographic factors were found between chronic persistent hepatitis of viral B etiology and sex; chronic persistent hepatitis of alcoholic etiology and provenience environment; chronic hepatitis of alcoholic etiology with moderate histological activity and the level of gammaglobulin; chronic hepatitis of viral B etiology with severe histological activity and sex of patients; chronic hepatitis of viral C etiology with severe histological activity and ASAT and ALAT levels and between chronic hepatitis of alcoholic etiology with severe histological activity.
Conclusions: Repeated viral alcoholic aggressions on liver produce significant changes in the liver cell and correlations between demographic, clinic and histopathologic changes can predict further evolution, prognosis and response to the treatment.

Keywords: chronic hepatitis, morphometry, immunohistochemistry, fibrosis