種々の肝疾患時におけるastrocyteの病理組織学的研究—Alzheimer II型gliaについて

HISTOPATHOLOGICAL STUDIES ON ASTROCYTE IN VARIOUS LIVER DISEASES : A STUDY OF ALZHEIMER GLIA TYPE II

I．はじめに

　今日，種々の肝疾患時におけるastrocyteの異型化とその核内封入体（ベストカルミン腸性顆粒）の出現はよく知られている。貴田^14）は先般Alzheimer II型glia核内封入体について詳細に報告したが，同時に肝病理所見および臨床所見とAlzheimer II型glia （A-II型glia）との相関についても統計的に対比検討したのでここに報告する。

In order to study the histopathological changes of astrocyte in liver diseases, 72 autopsy cases of various liver diseases such as liver cirrhosis, hepato-cellular carcinoma, acute hepatic necrosis, and etc., except for Wilson's disease were studied and 15 cases without liver lesion were studied as a control. Alzheimer glia type II (A-II glia) was found in 62 cases out of 72 cases with liver disease and 5 cases among 15 control cases. Statistically, a significant difference of the incidence of A-II glia was seen between the cases with liver disease and control group (p<0.01). Histological changes of A-II glia were classified into three stages according to Stadler's staging.

In the cases with liver disease, A-II glias of stage II and III were predominant, whereas in control group stage I was predominant with a statistic significance (p<0.01). In most cases with liver disease, A-II glia was remarkably seen in corpus striatum and dentate nuclei with a significant dif-ference of that in cerebral cortex (p<0.01).

In liver cirrhosis of Miyake's type A, A-II gliasof stage III were predominant, whereas in liver cirrhosis Miyake's type B A-II glias of stage II were predominant, and in the cases of acute hepatic necrosis A-II glias of stage I were predominant. In general, stronger degeneration of astrocyte was recognized in the cases of cirrhosis without hepa-tocellular carcinoma than in the cases with hepa-tocellular carcinoma.

There was no relationship between the size of primary and or metastatic hepatic tumors and the incidence and the stage of A-II glias. In concern to the incidence and the stage of A-II glias, no significant difference was seen between metastatic hepatic tumors and hepatocellular carcinoma.

There was no relationship between spleen weight and A-II glia.

Furthermore, no relationship was seen between esophageal varices and A-II glia. There was a close relationship between A-II glia and conscious-ness disturbance, especially, in the cases presenting prolonged or repeated consciousness disturbance.

There was a positive correlation between serum ammonia levels, and the incidence and the stage of A-II glia. Also, there was relationship between ICG (or BSP) test and A-II glia.

No relationship was seen between serum trans-aminase and A-II glia, and between blood sugar levels and A-II glia, and between BUN and A-II glia.