Apoptosis and Cell Proliferation in Biliary Atresia

胆道闭锁（BA）被认为是由于坏死性炎症过程对胆管的进行性破坏，是婴儿期梗阻性黄疸的最常见原因。BA在重塑导管板组织中的降解是重要的致病因素之一，但对BA的细胞更新研究很少。采用原位末端标记法（TUNEL）和Ki 67免疫组化染色法检测了34例BA的细胞凋亡和程序性死亡，并与正常对照组进行了比较胆管TUNEL标记指数（LI）为48.9 × 13.2%，明显高于正常对照肝（3.6 × 2.8%）和先天性胆管扩张（CDB）（2.5 × 5.1%）。BA胆管Ki 67 LI（15.0 × 5.57%）明显高于CDB（8.6 × 5.4%）。BA、CDB和正常肝组织中TUNEL和Ki 67 LI无显著性差异。BA胆管TUNEL阳性率明显高于Ki 67阳性率，BA与胆管细胞更新增多、紊乱有关，与胆管板畸形或胆管发育异常有关。

Biliary atresia (BA), which is thought to result from progressive destruction of the bile ducts by a necroinflammatory process, is the most common cause of obstructivejaundice in infancy. Abnormalities in the tissues of remodeling ductal plates are one of the important etiologic factors but little has been studied in cell turnover of BA.Therefore, we examined programmed cell death or apoptosis by TdT-mediated dUTP biotin nick end labeling (TUNEL) and cell proliferation by Ki67 mmunostainingin in 34 cases of BA and compared the results with those of the normal control liver ( 5 cases ) and congenital dilatation of bile ducts (CDB, 5 cases) in order to study cell turnover or tissue dynamics of BA.TUNEL labeling index (LI) in bile ducts (48.9*13.2%) was significantly higher than that of the control normal liver (3.6*2.8%) and of CDB (2.5*5.1%). Ki67 LI in bile ducts of BA (15.0*5.57%) was also significantly higher than that of CDB (8.6*5.4%). No significant differences of TUNEL and Ki67 LI in hepatocytes were , however, observed among the cases with BA, CDB and normal liver. TUNEL LI was significantly higher than Ki67 LI in bile ducts of BA.BA is associated with increased and disorganized cell turnover of the bile ducts, which are related to ductal plate malformation or abnormal bile duct development.