National Center of Pathology, Vilnius University, Lithuania.
Medicina (Kaunas). 2011;47(1):31-8.
The aim of this study was to estimate cytokeratin 7 (CK-7) expression in biopsy specimens of patients with different stages of primary biliary cirrhosis and clinicopathological patterns (cholestatic and hepatitic) and its correlation with some biochemical and pathological parameters and to examine a diagnostic value of CK-7 expression.
A total of 82 biopsy specimens of patients with primary biliary cirrhosis were analyzed. CK-7 expression was graded by 4 grades depending on the extent into parenchymal areas and bile duct epithelium. The correlations of CK-7 expression grade with copper deposition, bile duct/portal tract ratio, bilirubin concentration, and activity of alkaline phosphatase and gamma-glutamyl transpeptidase were studied. CK-7 expression was evaluated as a marker of cholestasis (cholestatic pattern) and inflammation (hepatitic pattern).
A positive correlation of CK-7 expression grade with copper-binding protein grade (r=0.698, P<0.0001; OR=6.199, P<0.0001), serum bilirubin level (r=0.375, P=0.001), and alkaline phosphatase activity (r=0.276, p=0.014) was found. CK-7 expression grades correlated positively with histological stages of primary biliary cirrhosis (r=0.639, P<0.000) and negatively with granulomas (r=-0.432, P<0.0001; OR=0.173, P=0.0011).
CK-7 expression is a sensitive marker of bile duct injury, which correlated well with histological stages of primary biliary cirrhosis, copper deposits, and biochemical markers of cholestasis: serum bilirubin level and alkaline phosphatase activity. Evaluation of CK-7 expression may improve the diagnosis of this serious and progressive disease. It is recommended to evaluate copper staining together with cytokeratin 7 expression in liver biopsy specimens for more precise diagnostic evaluation of asymptomatic primary biliary cirrhosis.
本研究旨在评估原发性胆汁性肝硬化不同阶段患者活检标本中细胞角蛋白 7（CK-7）的表达及其与某些生化和病理参数的相关性，并探讨 CK-7 表达的诊断价值。
共分析了 82 例原发性胆汁性肝硬化患者的活检标本。根据实质区和胆管上皮的范围，CK-7 表达分为 4 个等级。研究 CK-7 表达等级与铜沉积、胆管/门脉比值、胆红素浓度以及碱性磷酸酶和γ-谷氨酰转肽酶活性的相关性。CK-7 表达被评估为胆汁淤积（胆汁淤积型）和炎症（肝炎型）的标志物。
CK-7 表达等级与铜结合蛋白等级呈正相关（r=0.698，P<0.0001；OR=6.199，P<0.0001），与血清胆红素水平（r=0.375，P=0.001）和碱性磷酸酶活性（r=0.276，P=0.014）呈正相关。CK-7 表达等级与原发性胆汁性肝硬化的组织学分期呈正相关（r=0.639，P<0.000），与肉芽肿呈负相关（r=-0.432，P<0.0001；OR=0.173，P=0.0011）。
CK-7 表达是胆管损伤的敏感标志物，与原发性胆汁性肝硬化的组织学分期、铜沉积以及胆红素水平和碱性磷酸酶活性等胆汁淤积的生化标志物密切相关。评估 CK-7 表达可能有助于提高对这种严重且进行性疾病的诊断。建议在肝活检标本中同时评估铜染色和细胞角蛋白 7 表达，以更准确地评估无症状原发性胆汁性肝硬化。
