Clinical And Pathological Characterization Of 83 Ases Of Primary Biliary Cirrhosis

Objective: To explore the clinical and pathological features of primary biliary cirrhosis(PBC). Methods: clinical data of 83 cases of PBC were reviewed, including general status, the clinical manifestation, laboratory findings and pathologic feathers Results: Among 83 patients, 76 were females(91.6%), 7 were males(8.4%), the mean age was(53.48±11.8)years old. The major symptoms in these patients were fatiguc (75.9%),anorexia(66.3%),jaundice(51.8%) and pruitus(21.7%). The levels of serum alkaline phosphatase(ALP)(330.58±255.03)U/L and serum gammaglutamyl transpeptidase (GGT)(255.58±234.65)U/L were very high. Whereas ALT and AST Ievels were mildly to moderately elevated (85.58±72.84)U/L and(93.24±63.15)U/L。Forty four patients( 53%) had a total bilirubin level≥28umol/L. Immune function was abnormal. The positive percentage of antinuclear antibody(ANA) is 60.2%,antibody of antimitoch-ondrial M2 subtype(AMA-M2) 71.1% and anti-mitoch-ondrial (AMA) 88%. Thirty seven patients (64.9%) had elevated serum IgM. Fifty two patients (92.9%) had elevated serum ESR. The main histopathological changes focus on small bile duct vanish(8/21), hyperplasy(15/21), infiltration of lym pholeukocyte around the bile duct(16/21), Infiltration of cell in header lympholeukocyte(20/16), parts of cases shaped lymphocyte folliculus(3/21), plas-mocyte(18/21), neutrophilic granulocyte(4/21),. Hepatic cell changes piecemeal necrosis(4/21), punctiform necrosis(15/21), focus-form necrosis(6/21), edema(18/21), bile accumulation(4/21), fibrosis fibroplasias(4/21), pseudo-lobulation(5/21). Conclusion: PBC most frequently affects middle-agcd wom en and the main clinical manifestations are jaundice and some patients are asymptomatic atearly stage. Elevated serum ALP andγ-GT levels together with positive AMA/AMA-M2 can help to diagnose. Liver biopsy is useful to confirm the diagnosis and differentiate histopathological stages.