Immunohistochemistry of the liver and biliary tree in extrahepatic biliary atresia.

摘要: Abstract Background: Progressive destruction of intrahepatic bile ducts may determine outcome in extrahepatic biliary atresia (EHBA) despite successful portoenterostomy. The aim this study was to characterize the inflammatory infiltrate a large series cases and relate these findings clinical outcome. Methods: Immunohistochemical analysis performed on frozen tissue sections tree liver biopsies obtained (August 1996 March 1998) from 28 infants with EHBA 8 biopsy specimens age-matched controls other cholestatic disorders. A semiquantative scoring system designed evaluate staining panel antibodies CD4, CD8, CD25, CD56, CD68, CD71 antigens HLA-DR, ICAM-1, VCAM-1, E-selectin LFA-1. then underwent followup prospectively divided into 2 prognostic groups at 12 months postoperatively: those who had cleared their jaundice (graded as good [n = 19]), required transplantation or failed clear (defined > 50 μmol/L; graded poor 9]). Results: CD4 + lymphocytes CD56 (NK cells) predominated compared controls. infiltrating cells exhibited marked proliferation (CD71 expression) activation (particularly LFA-1 but also CD25 expression). smaller subpopulation expressed VCAM E-selectin. HLA-DR strongly Kupffer lesser extent proliferating sinusoidal endothelium. Expression majority markers lower remnant duct than ( P =.05) remnant. Conclusions: patterns immune-mediated injury inflammation were prevalent features time They neither exclusive nor characteristic EHBA. reduction expression macrophage marker (CD68) within remnants ICAM-1 appear be associated better postoperative prognosis. J Pediatr Surg 36:1017-1025. Copyright © 2001 by W.B. Saunders Company.