Application of histology,immunohistochemistry and fluorescence in the diagnosis and differential diagnosis of autoimmune liver disease
Objective Autoimmune hepatitis(AIH),primary biliary cholangitis(PBC),AIH-PBC overlap syn-drome(OS)and drug-induced autoimmune-like hepatitis(DI-AILH)were studied by combining clinical features,his-topathology,immunohistochemical staining and immunofluorescence staining.To explore the clinicopathological features that are helpful for their differential diagnosis.Methods The histological,immunohistochemical and immunofluores-cence differences among AIH,PBC and OS.AIH and DI-AILH were quantitatively analyzed.Logistic regression model was established according to the significant difference factors between DI-AILH and AIH.Results As for histological evaluation,AIH showed significant interface hepatitis,Rosette formation,and clustered plasma cell infiltration at the boundary plate.There were plasma cell infiltration and obvious lymphocytic interlobular cholangitis in the portal area of PBC.OS showed higher grades of portal and intralobular inflammation.Immunohistochemical and immunofluorescence semi-quantitative scores showed significant differences in the positive cells in the portal area and the boundary plate be-tween AIH and PBC,intralobular and portal deposition of IgG in AIH,linear deposition of IgA along interlobular bile ducts in PBC.There were significant differences in plasma cells,neutrophil infiltration and lamina inflammation between DI-AILH and AIH,and the area under the curve of the Logistic regression model was greater than 0.80.Conclusion jury,pathologists can also provide accurate diagnosis of AIH and DI-AILH.
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