Hepatic reticulo-endothelial function: a correlation of radioisotopic and immunohistochemical assessment

Using an immunoperoxidase staining technique for muramidase (lysozyme)-containing cells in liver biopsies, the Kupffer cell population has been compared with the isotope liver scan abnormalities in 43 patients with various liver diseases. A significantly greater degree of scintigraphic abnormality was seen in cirrhotics compared with non-cirrhotics using both a visually assessed scan scoring technique (p less than 0.001) and computer-generated spleen-to-liver (S-L) relative activity ratios (p less than 0.01). The mean muramidase-positive cell count in cirrhotic biopsies was not significantly different from that in non-cirrhotics, neither was there any significant difference between alcoholic and non-alcoholic liver disease. The liver mass was shown to be significantly greater (p less than 0.02) in alcoholic compared with non-alcoholic disease, but even if corrections were made for this, no significant differences were found. A significant (p less than 0.02) negative correlation was found between liver scan score and muramidase-positive cell count in patients with cirrhosis but not in non-cirrhotic disorders. No significant correlations were observed if the computer-derived liver mass was taken into consideration. These results suggest that the scan defect seen in liver disease cannot be explained by loss of Kupffer cells alone, although they are consistent with the hypothesis that intrahepatic shunting plays a significant role. Chronic alcohol ingestion does not in itself appear to be a major independent influence.