Akademik Veri Yönetim Sistemi
World Journal of Hepatology, cilt.14, sa.1, ss.260-273, 2022 (ESCI)
© The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reservedBACKGROUND Chronic viral B hepatitis (CHB) is a potentially life-threatening liver disease that may progress to liver failure and cirrhosis. Currently, although combinations ofdifferent laboratory methods are used in the follow-up and treatment of CHB, thefailure of these procedures in some cases has led to the necessity of developingnew approaches. In CHB, the intrahepatic expression pattern of viral antigens,including hepatitis B surface antigen (HBsAg), is related to different phases ofinflammation. However, many studies have focused on the intracytoplasmicproperties of HBsAg staining, and HBsAg positivity in liver tissue has not beenevaluated by objective quantitative methods.AIMTo investigate the relationship of image analysis-based quantitative HBsAgexpression and its staining patterns with clinicopathological factors and treatmentin CHB.METHODSA total of 140 liver biopsies from treatment-naïve cases with CHB infection wereincluded in this study. Following diagnosis, all patients were treated withentecavir (0.5 mg) and followed up at three-month intervals. The percentage ofimmunohistochemical HBsAg (p-HBsAg) expression in the liver was determinedin whole tissue sections of biopsies from each case by image analysis. Theimmunohistochemical staining pattern was also evaluated separately according to3 different previously defined classifications.RESULTSA positive correlation between p-HBsAg and serum levels of hepatitis B virus(HBV) DNA and HBsAg was observed (P < 0.001). The p-HBsAg value wassignificantly higher in younger patients than in older patients. When the groupswere categorized according to the hepatitis B e antigen (HBeAg) status in HBeAgpositivecases, p-HBsAg was correlated with HBV DNA, hepatitis activity index(HAI) and fibrosis scores (P < 0.001). In this group, p-HBsAg and HBsAgexpression patterns were also correlated with the viral response (VR) and theserological response (SR) (P < 0.001). Multivariate analysis revealed that p-HBsAgwas an independent predictor of either VR or SR (P < 0.001). In HBeAg-negativepatients, although HBsAg expression patterns were correlated with both HAI andfibrosis, no relationship was observed among p-HBsAg, clinicopathologicalfactors and VR.CONCLUSIONIn pretreatment liver biopsies, the immunohistochemical determination of HBsAgexpression by quantitative methods, beyond its distribution within the cell, maybe a good predictor of the treatment response, especially in HBeAg-positive cases