The role of CK7, Ki-67, CD34 and vimentin in the differentiation between biliary atresia and idiopathic neonatal hepatitis in Egyptian cholestatic neonates.
The differentiation between biliary atresia (BA) and idiopathic neonatal hepatitis (INH) is challenging with many histological overlaps especially in the first weeks of life. This study aimed to investigate the role of immunohistochemical staining of CK7, Ki67, CD34, and vimentin in addition to other clinicopathological features in the differentiation between BA and INH. Cases included 30 infants with BA and 30 infants with INH. The diagnosis was based on clinical, laboratory, and liver biopsy examination. Female gender and elevated serum gamma glutamyle transferase were in favor of BA. Portal tract changes, such as bile ductular proliferation documented by CK7, Ki67 immunostaining and angiogenesis documented by CD34 immunostaining, favored the diagnosis of BA. Copper associated protein was positive in 70% of BA cases, but not detected in INH cases. Parenchymatous changes, such as giant cell transformation and positive iron deposition and Kupffer cell proliferation documented by vimentin immunostaining, favored the diagnosis of INH.CK7, Ki67, CD34, and vimentin are helpful adjuvant immunostaining in the differentiation between BA and INH.
Department of Pathology, Faculty of Medicine, Menoufiya University, Egypt. hayamaiad@yahoo.com
Hayam Abdel Samie
HA
Aiad
Mona Abdel Halim
MA
Kandil
Rehab Monir
RM
Samaka
Mervat Mahmoud
MM
Sultan
Mohamed Tawfik
MT
Badr
Gammal Eldin Mahmoud
GE
Nada
D001656:Biliary Atresia / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D003937:Diagnosis, Differential; D004534:Egypt; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007223:Infant; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D053552:Keratin-7 / Q000378:metabolism; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D017452:Receptors, IgG / Q000378:metabolism; D012189:Retrospective Studies; D014746:Vimentin / Q000378:metabolism
D053552:Keratin-7; D019394:Ki-67 Antigen; D017452:Receptors, IgG; D014746:Vimentin