免疫检查点抑制剂诱导性药物性肝损伤的组织病理初探

肝脏 ›› 2025, Vol. 30 ›› Issue (4): 529-531.

免疫检查点抑制剂诱导性药物性肝损伤的组织病理初探

郭林林, 常静, 周光德

100069 首都医科大学附属北京佑安医院病理科

收稿日期:2024-07-08 出版日期:2025-04-30 发布日期:2025-06-17
通讯作者: 周光德,Email: guangdez@sina.com
基金资助:
国家重点研发计划课题(2023YFC2308101)

Preliminary study on histopathology of drug-induced liver injury induced by immune checkpoint inhibitors

Guo Linlin, Chang Jing, Zhou Guangde

Department of Pathology, Beijing You'an Hospital,Capital Medical University, Beijing 100069, China

Received:2024-07-08 Online:2025-04-30 Published:2025-06-17
Contact: ZHOU Guang-de, Email: guangdez@sina.com

摘要/Abstract

摘要： 目的探讨免疫检查点抑制剂诱导性药物性肝损伤(immune checkpoint inhibitors induced liver injury,ICIs-DILI)的组织病理学特点。方法对3份ICIs-DILI肝组织标本进行常规HE、罗丹宁法铜染色、普鲁士蓝法铁染色、及CD3、CD20、mum-1、CK19等免疫组化染色,观察ICIs-DILI的组织病理学改变。结果 3份肝组织均显示不同程度的淤胆、毛细胆管胆栓形成及肝细胞坏死,小叶内可见微小肉芽肿,小叶间胆管呈损伤性改变伴细胆管反应,汇管区轻-中度混合炎细胞浸润,可见浆细胞。结论 ICIs-DILI的肝细胞和胆管细胞均受累及。

关键词: 免疫检查点抑制剂, 免疫检查点抑制剂诱导性药物性肝损伤, 组织病理

Abstract: Objective To explore the histopathological characteristics of immune checkpoint inhibitor-induced liver injury (ICIs-DILI). Methods Three liver biopsy specimens of ICIs-DILI were stained with Hematoxylin eosin staining Rhodanine copper staining, Prussian blue iron staining, CD3, CD20, mum-1 and CK19 immunohistochemical staining, and the histopathological changes of ICIs-DILI were observed. Results All three cases showed cholestasis, bile thrombosis of canalicular cholestasis and hepatocyte necrosis in different degrees. Microgranuloma was found in lobules, interlobular bile duct was damaged with bile ductular reaction, and light-to-moderate mixed inflammatory cells infiltrated in portal area, and plasma cells were seen. Conclusion Liver histopathology of ICIs-DILI has its relative pathological characteristics, both hepatocytes and epithelial cells of bile duct are involved, especially the bile duct injury deserves clinical attention. The definite diagnosis of ICIs-DILI should be combined with clinic and pathology.

Key words: Immune checkpoint inhibitor, ICIs-DILI, Histopathology

郭林林, 常静, 周光德. 免疫检查点抑制剂诱导性药物性肝损伤的组织病理初探[J]. 肝脏, 2025, 30(4): 529-531.

Guo Linlin, Chang Jing, Zhou Guangde. Preliminary study on histopathology of drug-induced liver injury induced by immune checkpoint inhibitors[J]. Chinese Hepatolgy, 2025, 30(4): 529-531.

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