The correlation between liver fibrosis inflammatory infiltration and postoperative cholangitis after Kasai operation for children with biliary atresia / 天津医药

ABSTRACT

@# To analyze the relationship between the degree of hepatic fibrosis, the inflammatory cell infiltrationandthepostoperativecholangitisafterKasaioperationinchildrenwithbiliaryatresia(BA).Methods Atotalof 92childrendiagnosedasBAinourhospitalfromJanuary2015toDecember2016wereselectedinthisstudy.Patientswere dividedintohepaticfibrosisgradeⅠgroup(n=8),hepaticfibrosisgradeⅡgroup(n=31),hepaticfibrosisgradeⅢgroup(n= 35)andhepaticfibrosisgradeⅣgroup(n=18),accordingtoJapan’sOhkuma’shepaticfibrosisgradingcriteria.Combined with Kasai age, the relationship between hepatic fibrosis and surgical age was analyzed. Samples of liver tissues were evaluatedbyhematoxylin/eosin(HE)andMassonstaining.Theexpressionsofspecificinflammatorycellmarkerantibody LCA,CD4,CD8andCD68inliverwereobservedbyIHCstaining.Combinedwiththepostoperativefollow-updataofKasai, the relationship between the degree of inflammatory infiltration of liver tissue, the degree of hepatic fibrosis and the postoperative cholangitis of Kasai in BA children was analyzed. Results Routine pathological staining showed that lymphocytesinfiltratedmainlyinlivertissue.TheexpressionlevelsofLCAandCD4werehigheringroupⅠandgroupⅣ comparedwiththoseofgroupⅡandgroupⅢ.TherewasnosignificantdifferenceintheCD8expressionbetweenfour groups.All92childrenwithBAwerefollowedup.Itwasfoundthatcholangitisoccurredin 50cases,earlycholangitis occurredin38cases,andfrequentcholangitisoccurredin23cases.Theincidenceofcholangitis,earlycholangitis,and frequentcholangitisafterKasaisurgerywasstatisticallysignificantinBApatientswithdifferentgradesofhepaticfibrosis (P＜0.05). The incidence of cholangitis was higher in the groupⅠand group Ⅳ than that in groupⅡand group Ⅲ. Conclusion TheoccurrenceofcholangitisafterKasaioperationinchildrenwithBAiscorrelatedwiththehepaticfibrosis andliverinflammatorycells,especiallyTlymphocytesubgroups.