title: Diagnostic value of hepatic intercellular adhesion molecule-1 expression in Egyptian infants with biliary atresia and other forms of neonatal cholestasis.
abstract: OBJECTIVE
  The diagnosis of biliary atresia (BA) is challenging as no single preoperative test is 100% accurate, especially for distinguishing it from other causes of neonatal cholestasis (NC). Intercellular adhesion molecule (ICAM) elevation was reported in BA as a part of the immune-mediated inflammatory process. The use of ICAM-1 as a discriminative tool between BA and other causes of NC has never been addressed before. This study was to evaluate the diagnostic potentials of ICAM-1 in BA versus other forms of NC.
  
  
  METHODS
  For this purpose, serum ICAM-1 (sICAM-1) and ICAM-1 expression, in liver biopsy using immunohistochemistry, were estimated in 30 patients with BA and compared to that in 20 patients with other forms of NC. sICAM-1 levels were compared to that in 20 healthy controls.
  
  
  RESULTS
  sICAM-1 levels were significantly higher in BA (1055.9 ± 230.2 ng/mL) than that in cholestasis (604.8 ± 194.8 ng/mL) and the control groups (158.9 ± 78.7 ng/mL) (P < 0.0001). A cut-off value of 793.8 ng/mL had 86.7% sensitivity and 95% specificity in discriminating the BA from the cholestasis group. The biliary expression score of ICAM-1 at a cut-off value of 110 could discriminate between BA and other causes of NC with 100% sensitivity and specificity. Neither serum levels nor liver expression of ICAM-1 scores correlated with disease severity or with fibrosis stage.
  
  
  CONCLUSIONS
  These results suggest that ICAM-1 has a diagnostic value in patients with BA and would be a promising helpful tool when investigating patients with NC.
authors.affiliation: Departments of Microbiology and Immunology Pediatric Hepatology Pathology, National Liver Institute Department of Microbiology, Faculty of Medicine, Menofiya University, Shebin El-koom, Menofiya, Egypt.
authors.forename: Enas M
authors.initials: EM
authors.lastname: Ghoneim
authors.forename: Mostafa M
authors.initials: MM
authors.lastname: Sira
authors.forename: Azza M
authors.initials: AM
authors.lastname: Abd Elaziz
authors.forename: Fatma O
authors.initials: FO
authors.lastname: Khalil
authors.forename: Mervat M
authors.initials: MM
authors.lastname: Sultan
authors.forename: Ahmed B
authors.initials: AB
authors.lastname: Mahmoud