| Autor: |
Kotb, Magd A., El Henawy, Ahmed, Talaat, Sahaar, Aziz, Mona, El Tagy, Gamal H., El Barbary, Mohamed M., Mostafa, Wael |
| Předmět: |
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| Zdroj: |
Journal of Pediatric Surgery; Aug2005, Vol. 40 Issue 8, p1252-1257, 6p |
| Abstrakt: |
Abstract: Background: Hepatic fibrosis and cirrhosis develop progressively in extrahepatic biliary atresia (EHBA) despite timely surgical intervention. Purpose: The aim of the study was to define CD4+ helper T lymphocytes, cytotoxic CD8+ T lymphocytes, and CD68+ (macrophages) infiltration of portal tracts and lobules and hepatic fibrosis as possible predictive measures of outcome of infants having EHBA. Methods: The outcome of 32 infants with EHBA was correlated to their percutaneous biopsy and postportoenterostomy core liver tissue infiltration by CD4+, CD68+, and CD8+ cells and to the degree of detected fibrosis. Results: Portoenterostomy cores were heavily infiltrated by CD4+, CD8+, and CD68+, compared with the preoperative liver biopsy (P = .008, .004, and .017, respectively). Infants having favorable outcome had more macrophage infiltration in portoenterostomy core compared with those having an unfavorable outcome (25.66 ± 29.77 per HPF compared with 11.62 ± 4.58, P = .000). Mean CD4+/CD8+ ratio was 1.54 ± 1.37 in those who died within 18 months postoperatively and 0.733 ± 0.48 in others (P = .021). Conclusion: Immune-mediated destruction of portal tracts is an integral part of pathogenesis of EHBA. [Copyright &y& Elsevier] |
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