Immunohistochemistry of the liver and biliary tree in extrahepatic biliary atresia
Immunohistochemistry of the liver and biliary tree in extrahepatic biliary atresia
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DOI：
10.1053/jpsu.2001.24730
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发表时间：
2001-07-01
影响因子：
2.4
通讯作者：
Howard, ER
中科院分区：
文献类型：
--
作者：
Davenport, M;Gonde, C;Howard, ER
背景资料：肝外胆道闭锁（EHBA）尽管成功的门肠吻合术，但肝内胆管的进行性破坏可能决定其预后。本研究的目的是描述大量胆道闭锁病例中炎症浸润的特征，并将这些发现与临床结果联系起来。对肝外胆管树冰冻组织切片和肝活检标本进行免疫组化分析（1996年8月至1998年3月）从28例EHBA婴儿和8例肝活检标本，年龄匹配的对照与其他胆汁淤积性肝病。设计半定量评分系统以评价用一组抗CD 4、CD 8、CD 25、CD 56、CD 68、CD 71抗原和抗HLA-DR、ICAM-1、VCAM-1、E-选择素和LFA-1的抗体的染色。这些婴儿随后进行前瞻性随访，并在术后12个月时分为2个预后组：（在= 19]中评定为良好结局），以及那些需要肝移植或未能清除黄疸的患者（定义为> 50 μ mol/L;分级为不良结局[0 = 9]）结果：与对照组相比，EHBA患儿肝脏中CD 4（+）淋巴细胞和CD 56（+）（NK细胞）占优势。浸润细胞表现出显著的增殖（CD 71表达）和活化（特别是LFA-1，但也有CD 25表达）。一个较小的细胞亚群也表达VCAM和E-选择素。HLA-DR在枯否细胞上强烈表达，在增殖的胆管和窦内皮上表达程度较低。绝大多数标志物在残胆管组织中的表达低于肝组织（P
Background: Progressive destruction of intrahepatic bile ducts may determine outcome in extrahepatic biliary atresia (EHBA) despite successful portoenterostomy. The aim of this study was to characterize the inflammatory infiltrate of a large series of cases of biliary atresia and relate these findings to clinical outcome.Methods: Immunohistochemical analysis was performed on frozen tissue sections of extrahepatic biliary tree and liver biopsies obtained (August 1996 to March 1998) from 28 infants with EHBA and 8 liver biopsy specimens from age-matched controls with other cholestatic liver disorders. A semiquantative scoring system was designed to evaluate the staining with a panel of antibodies to the CD4, CD8, CD25, CD56, CD68, CD71 antigens and to HLA-DR, ICAM-1, VCAM-1, E-selectin and LFA-1. The infants then underwent followup prospectively and divided into 2 prognostic groups at 12 months postoperatively: those who had cleared their jaundice (graded as a good outcome in = 19]), and those who required liver transplantation or who had failed to clear their jaundice (defined as > 50 mu mol/L; graded as poor outcome [0 = 9])Results: CD4(+) lymphocytes and CD56(+) (NK cells) predominated in the liver of infants with EHBA as compared with controls. The infiltrating cells exhibited marked proliferation (CD71 expression) and activation (particularly LFA-1 but also CD25 expression). A smaller subpopulation of the cells also expressed VCAM and E-selectin. HLA-DR was strongly expressed on Kupffer cells and to a lesser extent on proliferating bile ducts and sinusoidal endothelium. Expression of the majority of markers was lower in the remnant bile duct tissue than in the liver of EHBA (P