title: Small epithelial cells in human liver cirrhosis exhibit features of hepatic stem-like cells: immunohistochemical, electron microscopic and immunoelectron microscopic findings.
abstract: OBJECTIVE
  To investigate whether cells with features similar to those of the oval cells of rodents and the small epithelial cells (SEC) recently described in certain human liver diseases, i.e. hepatic progenitor cells, also occur in human liver cirrhosis.
  
  
  RESULTS
  Surgical specimens from 35 cases of hepatitis B virus-positive cirrhosis (30 cases containing hepatocellular carcinoma) were investigated by immunohistochemical staining for cytokeratin 7 and albumin. Electron microscopic investigations, and immunoelectron microscopic investigations using the same antibodies and a double-labelling technique were performed in 15 and seven cases, respectively. SEC were observed in proliferated bile ductules, at the margins of regenerating nodules and in the fibrous septa in all cases of cirrhosis. The SEC were morphologically similar to the SEC described previously, and to the oval cells seen in experimental hepatocarcinogenesis. They were characterized by their small size, oval shape, scanty electron-dense or electron-lucent cytoplasm, a high nucleo-cytoplasmic ratio, tonofilaments and intercellular junctions. Immunoelectron microscopy revealed that the SEC co-expressed cytokeratin 7 and albumin. Both relatively undifferentiated SEC and SEC with morphological and immunophenotypical signs of differentiation towards biliary epithelial cells and hepatocytes were found.
  
  
  CONCLUSIONS
  SEC that exhibit morphological and immunophenotypical features of the SEC seen in certain other liver diseases are found in cirrhosis. These findings further support the hypothesis that a bipotent hepatic stem cell that may give rise to biliary epithelial cells and hepatocytes exists in the human liver.
authors.affiliation: Institute of Pathology, Ruijin Hospital, 2nd Medical University, Shanghai, China.
authors.forename: J-C
authors.initials: JC
authors.lastname: Xiao
authors.forename: P
authors.initials: P
authors.lastname: Ruck
authors.forename: A
authors.initials: A
authors.lastname: Adam
authors.forename: T-X
authors.initials: TX
authors.lastname: Wang
authors.forename: E
authors.initials: E
authors.lastname: Kaiserling
mesh_terms: D000418:Albumins / Q000378:metabolism; D001653:Bile Ducts, Intrahepatic / Q000378:metabolism / Q000473:pathology*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000378:metabolism / Q000473:pathology; D019084:Fluorescent Antibody Technique, Indirect; D006509:Hepatitis B / Q000150:complications / Q000473:pathology; D022781:Hepatocytes / Q000378:metabolism / Q000648:ultrastructure*; D006801:Humans; D053552:Keratin-7; D007633:Keratins / Q000378:metabolism; D008103:Liver Cirrhosis / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D008113:Liver Neoplasms / Q000150:complications / Q000378:metabolism / Q000473:pathology; D016253:Microscopy, Immunoelectron; D013234:Stem Cells / Q000378:metabolism / Q000473:pathology*
chemical_list: D000418:Albumins; C507497:KRT7 protein, human; D053552:Keratin-7; D007633:Keratins