Department of Cellular Pathology, Southampton General Hospital, Southampton, UK.
Histopathology. 2010 Mar;56(4):415-25. doi: 10.1111/j.1365-2559.2009.03391.x.
The study of cytokeratin expression has provided a valuable insight into the biliary microanatomy of the liver in health and disease. The canals of Hering are a putative site of origin for progenitor cells, which may repopulate the liver after cellular damage and loss. Normal bile ducts and the bile ductular reaction that occurs in many chronic liver diseases - especially chronic biliary tract disease - express cytokeratin (CK) 7 and CK19. Therefore, both ductopenia and the process of bile ductular reaction can be highlighted with immunohistochemistry for these cytokeratins. Furthermore, CK7 is usually expressed in an increasingly widespread manner by hepatocytes as chronic cholestatic liver disease progresses. For these reasons, CK immunohistochemistry is a very useful adjunct to morphological assessment and histochemical stains for copper retention when a diagnosis of chronic biliary disease is being considered. This review describes the anatomical theory behind the use of CK immunohistochemistry for the assessment of bile duct number and distribution in the liver and provides practical advice for the application of this technique in the diagnostic setting of common medical liver diseases.
细胞角蛋白表达的研究为肝脏在健康和疾病状态下的胆系微解剖提供了有价值的见解。Hering 管是祖细胞的可能起源部位，在细胞损伤和丢失后可能重新填充肝脏。正常胆管和许多慢性肝病（尤其是慢性胆道疾病）中发生的胆管反应表达细胞角蛋白 (CK) 7 和 CK19。因此，免疫组织化学染色可以突出显示这些细胞角蛋白的胆管减少和胆管反应过程。此外，随着慢性胆汁淤积性肝病的进展，CK7 通常在越来越广泛的范围内由肝细胞表达。出于这些原因，当考虑慢性胆道疾病的诊断时，CK 免疫组织化学是形态评估和铜潴留组织化学染色的非常有用的辅助手段。本综述描述了使用 CK 免疫组织化学评估肝脏胆管数量和分布的解剖学理论，并为该技术在常见医学肝脏疾病的诊断环境中的应用提供了实用建议。
