title: Peribiliary Gland Dilatation in Cirrhosis: Relationship with Liver Failure and Stem Cell/Proliferation Markers.
abstract: Dilated peribiliary glands (PBG) in patients with cirrhosis are often an incidental finding although their significance and physiopathology remain unclear. We aimed to identify clinical factors associated with dilated PBG and to perform a detailed morphometric assessment of dilated PBG in cirrhotic patients undergoing liver transplantation (LT).
  
  
  
  All consecutive cirrhotic patients undergoing LT at our institution between October 2006 and October 2011 were assessed for inclusion. Ten non-cirrhotic patients were included as controls. We performed morphometrical assessment of PBG, assessed baseline clinical factors associated with dilated PBG, immunohistochemistry staining with CK-19, MiB-1 and EpCAM, and radiological assessment of all available cases.
  
  
  
  Seventy-one patients met the inclusion criteria, 24% had PBG dilatation of >1000 µm. On multivariable analysis, MELD (OR 1.11 per unit increase in MELD, p = 0.004) was the only significant factor associated with dilated PBG. Compared to PBG < 1000 µm, large PBG had a higher proportion of EpCAM-positive (69 vs. 28%, p < 0.001) and MiB-1-positive lining cells (2.8 vs. 0.55%, p = 0.036). Computed tomography and magnetic resonance imaging had high specificity but low sensitivity for the diagnosis of dilated PBG > 1000 µm (specificity 90-100%, sensitivity 25-29%).
  
  
  
  Dilated PBGs are a common finding in explants of cirrhotic subjects undergoing LT and are associated with liver failure although diagnostic performance of cross-sectional imaging is inconstant. The high number of proliferative and EpCAM-positive cells lining the PBG may suggest a role of PBG in organ repair during liver failure.
authors.affiliation: Division of Gastroenterology and Hepatology, Geneva University Hospital, 4, Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland. nicolas.goossens@hcuge.ch.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Goossens
authors.affiliation: Radiology, University Hospitals of Geneva, Geneva, Switzerland.|Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Romain
authors.initials: R
authors.lastname: Breguet
authors.affiliation: Clinical Pathology, University Hospitals of Geneva, Geneva, Switzerland.|Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Claudio
authors.initials: C
authors.lastname: De Vito
authors.affiliation: Radiology, University Hospitals of Geneva, Geneva, Switzerland.|Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Terraz
authors.affiliation: Clinical Pathology, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Lin-Marq
authors.affiliation: Division of Gastroenterology and Hepatology, Geneva University Hospital, 4, Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland.|Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Giostra
authors.affiliation: Clinical Pathology, University Hospitals of Geneva, Geneva, Switzerland.|Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Laura
authors.initials: L
authors.lastname: Rubbia-Brandt
authors.affiliation: Division of Gastroenterology and Hepatology, Geneva University Hospital, 4, Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland.|Hepato-Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Laurent
authors.initials: L
authors.lastname: Spahr
mesh_terms: D000328:Adult; D001652:Bile Ducts / Q000000981:diagnostic imaging / Q000473:pathology; D003560:Cysts / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D004108:Dilatation, Pathologic; D000071858:Epithelial Cell Adhesion Molecule / Q000032:analysis / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D019394:Ki-67 Antigen / Q000032:analysis / Q000378:metabolism; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology; D017093:Liver Failure / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: C499379:EPCAM protein, human; D000071858:Epithelial Cell Adhesion Molecule; D019394:Ki-67 Antigen
keywords: Abdominal imaging; Cirrhosis; Immunohistochemistry; Liver failure; Peribiliary glands; Stem cell