Apoptosis and Cell Proliferation in Biliary Atresia

胆道闭锁（BA）被认为是由坏死性炎症过程对胆管的进行性破坏引起的，是婴儿期梗阻性黄疸的最常见原因。重塑导管板组织异常是BA的重要病因之一，但对BA的细胞转换研究甚少。因此，我们通过tdt介导的dUTP生物素缺口末端标记（TUNEL）检测了34例BA的程序性细胞死亡或凋亡，通过Ki67免疫染色检测了细胞增殖，并与正常对照肝（5例）和先天性胆管扩张（5例）的结果进行了比较，以研究BA的细胞更新或组织动力学。胆管TUNEL标记指数（LI）为48.9*13.2%，显著高于对照组正常肝脏（3.6*2.8%）和CDB（2.5*5.1%）。BA组胆管Ki67 LI含量（15.0*5.57%）显著高于CDB组（8.6*5.4%）。然而，BA、CDB和正常肝患者肝细胞中TUNEL和Ki67 LI含量无显著差异。BA胆管中TUNEL LI明显高于Ki67 LI。BA与胆管细胞周转增加和紊乱有关，这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.