Rubio C A
Department of Pathology, Karolinska Institute, Stockholm, Sweden.
J Clin Pathol. 2000 Oct;53(10):765-9. doi: 10.1136/jcp.53.10.765.
Lymphocytic infiltration in the portal triads usually conceals the detection--in haematoxylin and eosin (H&E) stained sections--of bile ducts in two liver diseases: chronic hepatitis and primary biliary cirrhosis. The aim was to assess the number and the characteristics of the bile ducts in those diseases with the aid of an antibody to cytokeratin 7 (CK7).
Consecutive sections from 99 liver biopsies were stained with H&E and anti-CK7.
In H&E sections the total number of central bile ducts in the triads was 52 in primary biliary cirrhosis (n = 37), 69 in chronic hepatitis (n = 43), and 30 in miscellaneous cases (n = 19). Using anti-CK7, the number of central bile ducts was 276 in primary biliary cirrhosis, 348 in chronic hepatitis, and 96 in miscellaneous cases. Central bile ducts with lumen were found in 93.0% of chronic hepatitis cases and in 89.5% of the miscellaneous cases, but in only 13.5% of the primary biliary cirrhosis cases. Peripheral bile ducts in groups of > or = 4/triad were found in all cases of chronic hepatitis (100%) and in 75.7% primary biliary cirrhosis cases, but only in 10.5% of the miscellaneous cases. In 21.6% of primary biliary cirrhosis cases, no bile ducts (central and/or peripheral) were present.
Anti-CK7 detects bile ducts in the triads that are concealed by chronic inflammatory cells. Central and peripheral bile ducts in groups of > or = 4 were significantly more common in primary biliary cirrhosis and chronic hepatitis than in other liver diseases. The lack of lumen in central bile ducts, as well as the absence of central and/or peripheral bile ducts in CK7 stained liver sections, seem to be valuable additional parameters in the differential diagnosis between primary biliary cirrhosis and chronic hepatitis.
在苏木精-伊红（H&E）染色切片中，门管区的淋巴细胞浸润通常会掩盖两种肝脏疾病（慢性肝炎和原发性胆汁性肝硬化）中胆管的检测。目的是借助细胞角蛋白7（CK7）抗体评估这些疾病中胆管的数量和特征。
对99例肝活检的连续切片进行H&E染色和抗CK7染色。
在H&E切片中，原发性胆汁性肝硬化（n = 37）门管区中央胆管总数为52个，慢性肝炎（n = 43）为69个，其他病例（n = 19）为30个。使用抗CK7染色，原发性胆汁性肝硬化中央胆管数量为276个，慢性肝炎为348个，其他病例为96个。在93.0%的慢性肝炎病例和89.5%的其他病例中发现有管腔的中央胆管，但原发性胆汁性肝硬化病例中仅为13.5%。在所有慢性肝炎病例（100%）和75.7%的原发性胆汁性肝硬化病例中发现每组≥4个的外周胆管，但其他病例中仅为10.5%。在21.6%的原发性胆汁性肝硬化病例中，不存在胆管（中央和/或外周）。
抗CK7可检测到被慢性炎症细胞掩盖的门管区胆管。原发性胆汁性肝硬化和慢性肝炎中每组≥4个的中央和外周胆管比其他肝脏疾病更常见。中央胆管缺乏管腔以及CK7染色肝切片中不存在中央和/或外周胆管，似乎是原发性胆汁性肝硬化和慢性肝炎鉴别诊断中有价值的额外参数。
