Analysis of the Pathomorphology of the Intra- and Extrahepatic Biliary System in Biliary Atresia

Zheng, Shusen; Luo, Yongheng; Wang, W; Xiao, Xu

doi:10.1055/s-2008-1038360

Cited by 15 publications

(13 citation statements)

References 16 publications

(18 reference statements)

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“…The cutoff values of transient elastography for predicting severe fibrosis and cirrhosis reported in previous studies varied, ranging from 7.9 to 11 and 11.0 to 25.8 kPa, respectively 24 – 29 . In our study, the cutoff values for diagnosis of severe fibrosis and cirrhosis were greater than 9.6 and greater than 18.1 kPa, which were comparable with values in previous studies 18 , 30 . Because most patients with biliary atresia had stage F2 fibrosis or higher, we could not evaluate the diagnostic performance of transient elastography for predicting substantial fibrosis (≥F2).…”

Section: Discussionsupporting

confidence: 87%

Transient Elastography and Sonography for Prediction of Liver Fibrosis in Infants With Biliary Atresia

Shin

Kim

Lee

et al. 2014

J of Ultrasound Medicine

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Objectives The purpose of this study was to assess the diagnostic performance of transient elastography and sonography for noninvasive evaluation of liver fibrosis in infants with biliary atresia. Methods Forty‐seven infants with biliary atresia who underwent both transient elastography and sonography before surgery were included in this study. Two types of transient elastographic probes were used: an M probe, which is used for the general adult population; and an S probe, which is specific to children. Transient elastographic measurements and sonographic findings such as triangular cord thickness and hepatic artery and portal vein diameters were compared with the METAVIR histopathologic fibrosis scoring system. Results Only transient elastography (ρ = 0.63; P < .001) was significantly correlated with METAVIR fibrosis stages. The areas under the receiver operating characteristic curves for transient elastography were 0.86 and 0.96 for diagnosis of severe fibrosis and cirrhosis, respectively. The cutoff value of transient elastography for diagnosis of severe fibrosis was greater than 9.6 kPa, with sensitivity of 89.5% and specificity of 75%. The cutoff value of transient elastography for diagnosis of cirrhosis was greater than 18.1 kPa, with sensitivity of 100% and specificity of 90.5%. The success rate for the S probe (100%) was significantly higher than that for the M probe (77%; P < .001). Conclusions Transient elastography may be a useful noninvasive method for diagnosis of severe fibrosis and cirrhosis and may help predict outcomes before surgery or invasive liver biopsy in infants with biliary atresia. The success rate of transient elastography in infants was improved by using the S probe.

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Section: Discussionsupporting

confidence: 87%

Transient Elastography and Sonography for Prediction of Liver Fibrosis in Infants With Biliary Atresia

Shin

Kim

Lee

et al. 2014

J of Ultrasound Medicine

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“…Ultrastructural studies have shown progressive loss of microvilli from well to poorly differentiated carcinomas. 10,33,37 The exact function of the apical endopeptidase CD10 is not well understood; however, it is involved in membrane transport, allowing reabsorption of amino acids by epithelium and paracrine signaling, and may also play a role in the cholehepatic shunt pathway of antioxidant glutathione and its derivatives. 4,30 Loss or decrease of CD10 expression had been reported in a variety of malignancies arising in organs normally expressing high levels of this transmembrane zinccontaining endopeptidase.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Utility of CD10 in Benign and Malignant Extrahepatic Bile Duct Lesions

Tretiakova

Antic

Westerhoff

et al. 2012

American Journal of Surgical Pathology

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CD10, a cell surface enzyme with neutral metalloendopeptidase activity, is a marker for intestinal epithelial brush border. It is also present in normal bile ducts and gallbladder epithelia but is absent in cholangiocarcinomas. However, the expression profile of CD10 in benign and malignant extrahepatic biliary lesions has not been studied. In this study, 69 biopsies, 9 resections, and 9 cell blocks prepared from fine-needle aspirations of the extrahepatic bile ducts from 86 patients were studied immunohistochemically for CD10 expression. The majority of cases contained normal biliary epithelium (NL, n=64), along with foci of benign or malignant lesions in various combinations. Benign lesions included reactive atypia (n=35), low-grade dysplasia of unknown significance (n=21), and bile duct adenoma (BDA, n=1). Malignant lesions included high-grade dysplasia (HGD, n=45) and invasive adenocarcinoma (IC, n=30). As expected, the NL showed strong continuous staining at the apical surface in all cases. Benign lesions were also CD10 positive in all but 3 cases; however, the staining pattern was discontinuous, with positive cells varying from 20% to 80%. None of the malignant lesions showed CD10 immunoreactivity, except for 2 HGD cases and 1 IC case, which exhibited focal staining. The Pearson χ2 and Fisher exact tests showed significant statistical difference in CD10 expression among the study groups (P<0.001). Our findings suggest that absence of CD10 expression in strips of atypical biliary epithelial cells may be a phenotype associated with malignant transformation and may serve as a useful marker to aid in the evaluation of bile duct biopsies, in which distinction between benign and malignant lesions on biopsies or cytology specimens can be extremely challenging because of limited sampling, crush artifact, and frequent inflammatory/reactive changes.

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“…[4] Although precise mechanisms for BA have not been elucidated, immunologic abnormalities have been proposed as a potential mechanism in the pathogenesis of BA. [5][6][7] Activated T helper (Th) cells and different Th-cell cytokines are considered to play an important role in BA pathophysiology. [8] Traditionally, clusters of differentiation (CD)4+ Th cells are divided into three main subsets, Th1, Th2, and Th3 cells, according to the types of cytokines they secrete.…”

Section: Introductionmentioning

confidence: 99%

The correlation between plasma cytokine levels in jaundice-free children with biliary atresia

Jian¹,

Wang²,

Lin³

et al. 2015

World J Pediatr

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Analysis of the Pathomorphology of the Intra- and Extrahepatic Biliary System in Biliary Atresia

Cited by 15 publications

References 16 publications

Transient Elastography and Sonography for Prediction of Liver Fibrosis in Infants With Biliary Atresia

Transient Elastography and Sonography for Prediction of Liver Fibrosis in Infants With Biliary Atresia

Diagnostic Utility of CD10 in Benign and Malignant Extrahepatic Bile Duct Lesions

The correlation between plasma cytokine levels in jaundice-free children with biliary atresia

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