肝结核与肺结核的病理特征及免疫微环境的特征描述
Characterization of pathological features and immune microenvironment in hepatic tuberculosis and pulmonary tuberculosis
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影响因子:4.8
分区:医学2区 / 免疫学2区 微生物学2区
发表日期:2024
作者:
Qiang Niu, Runrui Wu, Ke Pan, Xinlan Ge, Wen Chen, Rong Liu
DOI:
10.3389/fcimb.2024.1418225
摘要
肝结核（HTB）是少见的肠外结核，临床上类似肝脏恶性肿瘤，难以做出正确诊断。病理学是结核病诊断的金标准，但关于肝结核的病理特征报道较少。共考虑了32例肝结核病例，分析并比较其与肺结核（PTB）在病理特征和药物耐药性方面的差异。增强CT扫描显示在动脉期、静脉期和延迟期出现环状延迟增强。大多数肝结核病例为单发病变，发病最高在右叶，且平均病变体积小于肺结核。病理变化中肉芽肿的频率、肝结核组病变面积的总体比例以及foxp3+细胞的数量明显高于肺结核组。然而，两组的其他病理特征和免疫细胞数量没有统计学差异。进一步分析了病变周围正常组织的免疫微环境。结果显示，肝结核组的巨噬细胞和foxp3+细胞数量明显高于肺结核组。两组在药物耐药性方面无显著差异。综上所述，肝结核与肺结核在病理特征和免疫微环境的表现上存在显著差异，肝结核中肉芽肿的频率和病变面积的总体比例明显高于肺结核。
Abstract
Hepatic tuberculosis (HTB) is rare extrapulmonary tuberculosis that is clinically similar to liver malignancy, making it difficult for correct diagnoses. Pathology is the gold standard for tuberculosis diagnosis. However, there are few reports on the pathological features of HTB. A total of 32 HTB cases were considered and the differences in pathological features and drug resistance were analyzed and compared with those for pulmonary tuberculosis (PTB). Enhanced CT scans showed ring-shaped delayed enhancement during the arterial, venous, and delayed phases. Most HTB cases were single lesions, with the highest incidence in the right lobe, and the average lesion volume was smaller than that of PTB. The frequency of granuloma in pathological changes, the overall share of the lesion area in the HTB group, and the number of foxp3+ cells were significantly higher than in the PTB group. However, no statistically significant differences were observed between the two groups' other pathological features and immune cell numbers. The immune microenvironment of the normal tissues surrounding the lesion was further analyzed. The findings showed that the number of macrophages and foxp3+ cells in the HTB group was significantly higher than in the PTB group. No significant difference in drug resistance was detected between the HTB and PTB groups. In conclusion, there are substantial differences in the characterization of pathological feature and immune microenvironment between HTB and PTB. The frequency of granuloma and subsequent overall share of the lesion area was significantly higher in HTB compared to PTB.