Bile ductular proliferation as a prognostic factor in biliary atresia: an immunohistochemical assessment.
OBJECTIVE
The correlation between the histological findings of the intrahepatic biliary epithelium and postoperative bile drainage in biliary atresia (BA) was investigated.


METHODS
The patients with BA were classified into 2 groups, consisting of a good bile drainage group (GBD, n = 14, mean age at initial operation, 57.6+/-18.0 days) and a poor bile drainage group (PBD, n = 11, mean age at initial operation, 86.9+/-42.7 days). Liver specimens from an initial Kasai's operation were examined by immunostaining using anticytokeratin 7 (CK7) antibody and anti-MIB-1 antibody. The number of CK7-positive cells in the bile ductules was microscopically calculated within the 40-microm-thick interstitium along the limiting plate (LP), and the CK7-positive cell number per unit length of the LP was estimated. In addition, the MIB-1 index in bile ductules also was determined.


RESULTS
The number of CK7-positive cells in PBD was significantly higher than that in GBD (167.6+/-45.6 v 117.8+/-32.4/ mm, P<.05). However, the MIB-1 index in biliary cells did not differ between the 2 groups.


CONCLUSIONS
An increased number of intrahepatic bile duct epithelial cells in liver specimens at the initial operation may be a poor prognostic factor in BA and appears to depend on the duration of bile stasis rather than the degree of bile stasis.
Kinugasa
Y
Y
Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Nakashima
Y
Y
Matsuo
S
S
Shono
K
K
Suita
S
S
Sueishi
K
K
D000704:Analysis of Variance; D000911:Antibodies, Monoclonal / Q000378:metabolism*; D001653:Bile Ducts, Intrahepatic / Q000166:cytology / Q000473:pathology*; D001656:Biliary Atresia / Q000473:pathology* / Q000601:surgery; D015415:Biomarkers / Q000032:analysis; D002455:Cell Division; D046508:Culture Techniques; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D007231:Infant, Newborn; D053552:Keratin-7; D007633:Keratins / Q000032:analysis*; D008099:Liver / Q000166:cytology / Q000473:pathology; D008297:Male; D008940:Mitotic Index; D009687:Nuclear Proteins / Q000378:metabolism*; D012680:Sensitivity and Specificity
D000911:Antibodies, Monoclonal; D015415:Biomarkers; C507497:KRT7 protein, human; D053552:Keratin-7; D009687:Nuclear Proteins; D007633:Keratins