Cytokeratin 8 Immunohistochemistry Distinguishes Chronic Hepatitis C from Steatohepatitis
JP Cantor, JL Farber. Thomas Jefferson University Hospital, Philadelphia, PA
Background: Chronic hepatitis C (CHC) is frequently accompanied by varying degrees of steatosis, owing to the direct effects of HCV genotype 3, as well as the prevalence of obesity and alcohol abuse in these patients. The degree of steatosis is predictive of the rate of progression to cirrhosis and the response to therapy. Thus, the steatosis itself, rather than the immune response to HCV, may be a major cause of chronic injury in CHC. In searching for Mallory bodies in cases of steatohepatitis, we observed that both steatotic and ballooned hepatocytes lack the normal, membranous immunohistochemical reactivity for CK8. The present study sought to determine whether CK8 reactivity could serve to differentiate the relative contributions of the persistent virus infection and steatosis to the progression of CHC.
Design: 10 biopsies from each of the following 2 groups were stainined immunohistochemically for CK8: 1) CHC with an HAI score of at least 6 but with less than 10% steatotic hepatocytes; 2) steatohepatitis with a NASH score of at least 4.
Results: In all group 1 biopsies (CHC), the hepatocytes stained diffusely for CK8 (top). By contrast, in all group 2 biopsies (steatohepatitis alone), CK8 staining of the hepatocytes was markedly decreased or absent (bottom).
Conclusions: CK8 immunostaining was lost from steatotic hepatocytes. By contrast, CHC was characterized by retention of CK8. Thus, CK8 reactivity may provide an effective marker to differentiate the relative contributions of the persistent virus infection and steatosis to the ongoing liver cell injury in CHC.
Category: Liver & Pancreas
Monday, March 22, 2010 9:30 AM
Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 210, Monday Morning