Nakanuma Y, Ohta G
Liver. 1986 Aug;6(4):205-11. doi: 10.1111/j.1600-0676.1986.tb01067.x.
Proliferation of the two types of bile ductules, typical and atypical, in the portal and periportal areas was examined in various liver diseases other than cirrhosis to determine any difference in their immunohistochemical properties and presumed histogenesis. While the typical ductules with a well-formed lumen were frequently seen in a large spectrum of diseases, atypical ductules with a poorly defined lumen were encountered much more frequently in prolonged biliary diseases, including primary biliary cirrhosis and primary sclerosing cholangitis, than in nonbiliary hepatic diseases. Immunocytochemically, cytoplasmic keratin was intensively positive in typical ductules, and the degree of its intensity and extent was variable in atypical ductules. Simultaneously, some of the periportal hepatocytes revealed weak staining for keratin. Luminal borders of typical ductules usually revealed an expression of both carcinoembryonic antigen and epithelial membrane antigen, while atypical ductules and periportal hepatocytes lacked epithelial membrane antigen. The atypical ductules, together with the adjoining hepatocytes, appeared on occasion to form anastomosing cords in prolonged biliary diseases. Thus, atypical ductules seem likely to originate from ductular transformation of the periportal hepatocytes and the typical ductules might result from the proliferation of preexisting interlobular bile ducts and ductules.
在除肝硬化之外的各种肝脏疾病中，研究了门管区和门管周围区典型和非典型两种胆小管的增殖情况，以确定它们在免疫组化特性和推测的组织发生方面是否存在差异。虽然管腔结构良好的典型胆小管在多种疾病中都很常见，但管腔界定不清的非典型胆小管在包括原发性胆汁性肝硬化和原发性硬化性胆管炎在内的长期胆汁性疾病中比在非胆汁性肝脏疾病中更常见。免疫细胞化学显示，细胞质角蛋白在典型胆小管中呈强阳性，在非典型胆小管中其强度和范围存在差异。同时，一些门管周围的肝细胞对角蛋白呈弱阳性染色。典型胆小管的管腔边界通常同时表达癌胚抗原和上皮膜抗原，而非典型胆小管和门管周围的肝细胞缺乏上皮膜抗原。在长期胆汁性疾病中，非典型胆小管有时与相邻的肝细胞一起形成吻合索。因此，非典型胆小管似乎可能起源于门管周围肝细胞的胆管化生，而典型胆小管可能是由先前存在的小叶间胆管和胆小管增殖所致。
