ЭКСПРЕССИЯ BCL-2 В ТКАНИ ПЕЧЕНИ ПАЦИЕНТОВ С АУТОИММУННЫМИ ЗАБОЛЕВАНИЯМИ ПЕЧЕНИ И ХРОНИЧЕСКИМ ГЕПАТИТОМ С

Changes of apoptosis in liver cells are observed in patients with lesions of various etiologies. The aim of this study was a comparative evaluation of the expression of the antiapoptotic factor bcl-2 in liver at CHC and autoimmune liver diseases (AiLD). Immunohistochemical assessment of bcl -2 expression in biliary epithelial cells and non-parenchymal cells were performed in liver biopsies from 33 patients with liver disease (7 – with autoimmune hepatitis (AIH), 10 – with primary biliary cirrhosis (PBC), 6 – overlap syndrome AIH / PBC and 10 – with chronic hepatitis (CHC)). In all groups, the greatest density of bcl-2+ non-parenchymal cells showed in the portal area, moreover, the expression of bcl-2 in non-parenchymal cells at CHC patients was significantly lower than in the other groups. The interrelation between necroinflammatory activity and bcl-2 expression in non-parenchymal liver cells was found (r = 0,35), the relationship with the stage of fibrosis was not found. We were obtained statistically significant differences in bcl-2 expression in biliary epithelial cells by semi-quantitative assessment: in the majority of patients with PBC bcl-2 was expressed over 2/3 of cholangiocytes, at AIH and AIH/PBC patients bcl-2+ reaction was observed in 1/3–2/3 biliary cells, and all CHC patients had bcl-2 expression less than in 1/3 cholangiocytes (p <0.05). Differences between AIH and AIH/PBC of bcl-2 expression in cholangiocytes were not observed. The intensity of bcl-2 expression in biliary epithelial cells can be used as a differential diagnostic marker when necessary to differentiate AIH and CHC in controversial situations and, most importantly, AIH / PBC and PBC.Изменения процессов апоптоза в клетках печени наблюдаются при поражениях различной этиологии. Целью исследования явилась сравнительная оценка экспрессии антиапоптотического фактора bcl-2 в ткани печени при хроническом гепатите С (ХГС) и аутоиммунных заболеваниях печени. В биоптатах 33 пациентов с заболеваниями печени (7 – с аутоиммунным гепатитом (АИГ), 10 – с первичным билиарным циррозом (ПБЦ), 6 – с перекрестным синдромом АИГ/ПБЦ и 10 –с ХГС) проведена иммуногистохимическая оценка экспрессии bcl-2 в эпителии желчных протоков и непаренхиматозных клетках. В портальной зоне во всех группах выявлена наибольшая плотность bcl-2+ непаренхиматозных клеток, при этом экспрессия bcl-2 в непаренхиматозных клетках была достоверно ниже при ХГС, чем в других группах. Выявлена взаимосвязь между некровоспалительной активностью и экспрессией bcl-2 в непаренхиматозных клетках печени (r=0,35), взаимосвязи со стадией фиброза не выявлено. При полуколичественной оценке получены достоверные различия экспрессии bcl-2 клетками билиарного эпителия: при ПБЦ у большинства больных bcl-2 экспрессировали более 2/3 холангиоцитов, при АИГ и АИГ/ПБЦ bcl-2+ реакция отмечалась в 1/3–2/3 билиарных клеток, при ХГС у всех больных отмечена экспрессия bcl-2 менее, чем в 1/3 холангиоцитов (р<0,05). Различий между АИГ и АИГ/ПБЦ в экспрессии холангиоцитами bcl-2 не наблюдалось. Выраженность экспрессии bcl-2 клетками билиарного эпителия может использоваться как дифференциально-диагностический маркер при необходимости разграничения АИГ и ХГС в спорных ситуациях и, главное, АИГ/ПБЦ и ПБЦ

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