Immunohistochemical study of proliferating cell nuclear antigen in hepatocytes of biliary atresia: a parameter to predict clinical outcome.
The hepatic lobulus was studied histologically and immunohistochemically using the monoclonal antibody for proliferating cell nuclear antigen (PCNA/Cyclin, a cell-cycle-related nuclear protein) in 27 patients with biliary atresia (BA) and six normal infants. The study showed that the labeling index (LI) for PCNA-positive hepatocytes was 37.21 +/- 17.75% in the patients with BA and 3.14 +/- 1.5% in the normal infants (P < .0001). LI for PCNA-positive cells was higher in the periportal area than the pericentral area (P < .01). LI was not related to the patients' age at the time of hepatic portoenterostomy. LI was 20.80 +/- 7.03% for patients whose jaundice cleared postoperatively and 48.49 +/- 13.43% for patients who had persistent jaundice (P < .001). Conventional histological studies of the same specimens showed common findings of BA, such as hepatocellular degeneration, necrosis, inflammatory cell infiltration, and giant cell transformation. Most patients with BA had 8.94 +/- 13.55% giant cell transformation among 1,000 hepatocytes. Patients who exhibited high giant cell transformation had an unfavorable outcome. Only 0.42% of giant cells were immunoreactive for PCNA. In conclusion, the PCNA expression of hepatocytes is closely related to the prognosis of patients with BA, and thus could be used as a prognostic indicator.
Department of Surgery, Nagoya University School of Medicine, Japan.
M
M
Hossain
O
O
Murahashi
H
H
Ando
K
K
Iio
K
K
Kaneko
T
T
Ito
D001656:Biliary Atresia / Q000276:immunology* / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008099:Liver / Q000276:immunology* / Q000473:pathology*; D009336:Necrosis; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis*
D018809:Proliferating Cell Nuclear Antigen