METAPLASTIC LESIONS IN INTRAHEPATIC BILE-DUCTS IN HEPATOLITHIASIS - A HISTOCHEMICAL AND IMMUNOHISTOCHEMICAL STUDY
METAPLASTIC LESIONS IN INTRAHEPATIC BILE-DUCTS IN HEPATOLITHIASIS - A HISTOCHEMICAL AND IMMUNOHISTOCHEMICAL STUDY
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DOI：
10.1111/j.1440-1746.1990.tb01436.x
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发表时间：
1990-09-01
影响因子：
4.1
通讯作者：
NAKANUMA, Y
中科院分区：
文献类型：
--
作者：
KURUMAYA, H;TERADA, T;NAKANUMA, Y
对22例肝内胆管结石患者和7例正常肝组织进行了肝内胆管结石的病理检查，着重观察了胆管上皮化生。正常肝脏胆管壁内腺成分很少，无化生病变或内分泌细胞。在肝内胆管结石中，所有病例的管壁内均可见大量类似幽门腺的粘液腺(假幽门腺化生)。腺体上皮细胞对III类粘蛋白呈阳性反应，刀豆蛋白A呈反常染色，为幽门腺所特有。这些细胞也不同程度地呈中性粘蛋白、唾液酸粘蛋白和磺化粘蛋白阳性。肠化生，包括杯状细胞和潘氏细胞化生，5例(23%)位于管壁和覆盖上皮内。在这些化生病变中有13例(59%)存在内分泌细胞，包括嗜银细胞、嗜银细胞和含有胃肠激素的细胞。内分泌细胞的出现与肠化生密切相关，尽管化生的假幽门腺内有少量内分泌细胞。这些发现表明，肝内胆管壁的化生病变与众所周知的胆囊化生病变相似，发生在肝内胆管结石中。化生病变和内分泌细胞的出现可能与肝内胆管结石相关的慢性炎症过程有关。
Pathology of the intrahepatic bile ducts bearing calculi was examined with an emphasis on metaplasia in 22 cases of hepatolithiasis and in seven cases of normal livers. Normal livers contained few glandular elements within the bile duct walls and no metaplastic lesions or endocrine cells. In hepatolithiasis, a number of mucous glands resembling pyloric glands (pseudopyloric gland metaplasia) were seen within duct walls in all cases. The epithelial cells of the glands were positive for class III mucin with paradoxical concanavalin A staining which is known to be specific for pyloric glands. These cells were also positive for neutral, sialo- and sulfomucin to a variable extent. Intestinal metaplasia, including goblet cell and Paneth cell metaplasia, was found within duct walls and in covering epithelia in five (23%) cases. Endocrine cells, including argyrophil, argentaffin and gut hormone-containing cells were present in these metaplastic lesions in 13 (59%) cases. The occurrence of endocrine cells was closely associated with intestinal metaplasia, although there were a few endocrine cells in metaplastic pseudopyloric glands. These findings suggest that metaplastic lesions similar to the well-known metaplastic lesions in the gallbladder occur in the intrahepatic bile duct walls in hepatolithiasis. The appearance of metaplasic lesions and endocrine cells may be causally related to chronic inflammatory processes associated with hepatolithiasis.