Departments of Microbiology and Immunology Pediatric Hepatology Pathology, National Liver Institute Department of Microbiology, Faculty of Medicine, Menofiya University, Shebin El-koom, Menofiya, Egypt.
Hepatol Res. 2011 Aug;41(8):763-75. doi: 10.1111/j.1872-034X.2011.00832.x.
The diagnosis of biliary atresia (BA) is challenging as no single preoperative test is 100% accurate, especially for distinguishing it from other causes of neonatal cholestasis (NC). Intercellular adhesion molecule (ICAM) elevation was reported in BA as a part of the immune-mediated inflammatory process. The use of ICAM-1 as a discriminative tool between BA and other causes of NC has never been addressed before. This study was to evaluate the diagnostic potentials of ICAM-1 in BA versus other forms of NC.
For this purpose, serum ICAM-1 (sICAM-1) and ICAM-1 expression, in liver biopsy using immunohistochemistry, were estimated in 30 patients with BA and compared to that in 20 patients with other forms of NC. sICAM-1 levels were compared to that in 20 healthy controls.
sICAM-1 levels were significantly higher in BA (1055.9 ± 230.2 ng/mL) than that in cholestasis (604.8 ± 194.8 ng/mL) and the control groups (158.9 ± 78.7 ng/mL) (P < 0.0001). A cut-off value of 793.8 ng/mL had 86.7% sensitivity and 95% specificity in discriminating the BA from the cholestasis group. The biliary expression score of ICAM-1 at a cut-off value of 110 could discriminate between BA and other causes of NC with 100% sensitivity and specificity. Neither serum levels nor liver expression of ICAM-1 scores correlated with disease severity or with fibrosis stage.
These results suggest that ICAM-1 has a diagnostic value in patients with BA and would be a promising helpful tool when investigating patients with NC.
胆道闭锁（BA）的诊断具有挑战性，因为没有一种术前检查是 100%准确的，尤其是在将其与其他新生儿胆汁淤积（NC）病因区分开来时。细胞间黏附分子（ICAM）升高已被报道为 BA 免疫介导的炎症过程的一部分。以前从未有人研究过 ICAM-1 作为 BA 与其他 NC 病因之间的鉴别工具。本研究旨在评估 ICAM-1 在 BA 与其他 NC 形式之间的诊断潜力。
为此，我们评估了 30 例 BA 患者和 20 例其他 NC 患者的血清 ICAM-1（sICAM-1）和 ICAM-1 表达（通过免疫组化在肝活检中），并将其与 20 例健康对照者进行比较。
BA 患者的 sICAM-1 水平（1055.9±230.2ng/ml）明显高于胆汁淤积（604.8±194.8ng/ml）和对照组（158.9±78.7ng/ml）（P<0.0001）。以 793.8ng/ml 为截断值，可区分 BA 与胆汁淤积组，其灵敏度为 86.7%，特异性为 95%。以 110 为截断值的 ICAM-1 胆道表达评分可 100%的灵敏度和特异性区分 BA 与其他 NC 病因。sICAM-1 水平或 ICAM-1 表达评分均与疾病严重程度或纤维化分期无关。
这些结果表明，ICAM-1 在 BA 患者中有诊断价值，在对 NC 患者进行检查时可能是一种很有前途的有用工具。
