Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Histopathology. 2011 Nov;59(5):867-75. doi: 10.1111/j.1365-2559.2011.04011.x.
Hitherto, biliary intraepithelial neoplasia (BilIN) has been described in chronic biliary disease but rarely in non-biliary liver cirrhosis (LC). Intraepithelial neoplasia of the pancreas shows alterations in the expression of cell cycle and mucin core proteins. The aim of this study was to evaluate BilIN and reactive biliary lesions in biliary disease and non-biliary LC.
BilIN was found in 51% (33 of 65) of liver tissue cases of biliary disease, and in 11% (34 of 310) of the LC group. Immunohistologically, MUC5AC, an 'early phase' protein, and Ki67, reflecting 'late phase' expression, were identified with increasing degrees of dysplasia in both groups, but that expression was significantly higher in the biliary disease group. 'Early phase' cell cycle proteins, p16 (decrease) and p21 (increase) altered in both biliary and LC groups with increasing degrees of dysplasia.
We found BilIN in the large bile ducts of hepatitis B virus- and hepatitis C virus-related LC as well as in cases related to a biliary aetiology. The LC group was significantly less likely to show changes in the expression of MUC5AC and proliferative activity than the biliary group. Alterations in p16 and p21 reflected increasing degrees of dysplasia in both groups.
迄今为止，胆管上皮内瘤变（BilIN）已在慢性胆道疾病中被描述，但在非胆汁性肝硬化（LC）中很少见。胰腺上皮内瘤变显示细胞周期和粘蛋白核心蛋白表达的改变。本研究旨在评估胆道疾病和非胆道 LC 中的 BilIN 和反应性胆管病变。
BilIN 在胆道疾病的 51%（65 例中的 33 例）和 LC 组的 11%（310 例中的 34 例）肝组织病例中被发现。免疫组织化学显示，在两组中，随着发育不良程度的增加，MUC5AC（“早期”蛋白）和 Ki67（反映“晚期”表达）均被识别，但胆道疾病组的表达明显更高。在胆道和 LC 两组中，随着发育不良程度的增加，“早期”细胞周期蛋白 p16（减少）和 p21（增加）发生改变。
我们在乙型肝炎病毒和丙型肝炎病毒相关 LC 的大胆管中以及与胆道病因相关的病例中发现了 BilIN。LC 组的 MUC5AC 表达和增殖活性改变的可能性明显低于胆道组。p16 和 p21 的改变反映了两组中发育不良程度的增加。
