Promyelocytic leukemia antigen expression: A histological marker for primary biliary cholangitis diagnosis?
| Autor: | George K. Koukoulis, Maria Ioannou, George N. Dalekos, Nikolaos K. Gatselis, Panagiotis Papamichalis, Roidoula Papamichali, Kalliopi Zachou |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Pathology Anti-nuclear antibody 030204 cardiovascular system & hematology digestive system Primary sclerosing cholangitis 03 medical and health sciences Promyelocytic leukemia protein 0302 clinical medicine anti-PML antibodies Internal medicine Internal Medicine Medicine anti-nuclear antibodies biology primary biliary cholangitis business.industry primary sclerosing cholangitis medicine.disease digestive system diseases Leukemia immunohistochemical staining Monoclonal biology.protein Immunohistochemistry Original Article 030211 gastroenterology & hepatology business Viral hepatitis Immunostaining |
| Zdroj: | Journal of Translational Internal Medicine |
| ISSN: | 2224-4018 |
| DOI: | 10.2478/jtim-2021-0008 |
| Popis: | Background and Objectives Distinguishing primary biliary cholangitis (PBC) from other cholestatic diseases at the histological level could be assisted by new methods, such as immunohistochemical staining of specific antigens. Methods We evaluated whether the detection of promyelocytic leukemia protein (PML) can serve as a specific and sensitive marker for PBC diagnosis. Liver biopsies from 26 PBC patients, 20 primary sclerosing cholangitis (PSC), 37 viral hepatitis, 11 non-alcoholic steatohepatitis (NASH) and 5 normal patients were investigated after immunostaining with the anti-PML monoclonal PG-M3, IgG1 antibody. Results Immunoreactivity in bile ducts was expressed by the PML-score (quotient of positive ducts to the total number of portal tracts multiplied by 2). PML-score was higher in PBC as compared to controls (P < 0.001). Using a cutoff of 0.18, PML-score proved highly sensitive (84.6%) and specific (89.7%) for confirming PBC as compared to only 5% of PSC, 9.1% of NASH and 13.5% of viral hepatitis patients (P < 0.001). Irrespective of the underlying disease, patients with PML-score > 0.18 were older (P = 0.007), more often females (P < 0.001) with higher ALP (P < 0.001), γ-GT (P = 0.001) and IgM (P < 0.001) compared to the patients with PML-score < 0.18. Conclusions We postulate that a simple PML immunohistochemical test could be sufficient for histopathological discrimination of PBC in problematic cases of undefined cholestatic disorders, including small-duct PSC and AMA-negative PBC cases. |
| Databáze: | OpenAIRE |
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