Obayashi Juma, Kawaguchi Kohei, Manabe Shutaro, Nagae Hideki, Wakisaka Munechika, Koike Junki, Takagi Masayuki, Kitagawa Hiroaki
Division of Pediatric Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan.
Department of Pathology, St. Marianna University School of Medicine, Kawasaki, Japan.
Pediatr Surg Int. 2017 Oct;33(10):1047-1052. doi: 10.1007/s00383-017-4135-y. Epub 2017 Aug 29.
The number of the bile ducts in the portal canal/measured surface area of the portal canal (BDP ratio) indicates prognosis in biliary atresia (BA), as does an elevated cytokeratin 7 positivity percentage (PCK7). We compared these two markers.
We reviewed 32 BA cases undergoing Kasai operation from 1976 to 2016 with >5 portal canals in biopsy samples. Group I required liver transplantation or died within a year of operation (n = 8). Group II survived with their native liver (n = 24). We determined the BDP ratio (10/mm) and PCK7 (%), subdividing patients into three groups by their age at operation: Group A ≤60 days (n = 6, 1 Group I), 60< Group B ≤90days (n = 16, 5 Group I), Group C >90 days (n = 10, 2 Group I).
PCK7 (%) was 2.71 ± 1.87 in Group I and 4.25 ± 2.56 in Group II (p = 0.13). BDP ratio (10/mm) was 1.19 ± 0.424 in Group I and 1.64 ± 0.534 in Group II (p = 0.04). Both markers were higher in Group C than in Group A or B (p < 0.01).
The BDP ratio is a better prognostic indicator than PCK7 in BA.
门静脉区域内胆管数量与门静脉区域测量表面积的比值（BDP 比值）可提示胆道闭锁（BA）的预后，细胞角蛋白 7 阳性率（PCK7）升高时亦是如此。我们对这两种标志物进行了比较。
我们回顾了 1976 年至 2016 年间接受 Kasai 手术的 32 例 BA 病例，其活检样本中的门静脉区域超过 5 个。第一组在术后一年内需要肝移植或死亡（n = 8）。第二组依靠自身肝脏存活（n = 24）。我们测定了 BDP 比值（每平方毫米 10 个）和 PCK7（%），根据手术时的年龄将患者分为三组：A 组≤60 天（n = 6，其中 1 例属于第一组），60＜B 组≤90 天（n = 16，其中 5 例属于第一组），C 组＞90 天（n = 10，其中 2 例属于第一组）。
第一组的 PCK7（%）为 2.71±1.87，第二组为 4.25±2.56（p = 0.13）。第一组的 BDP 比值（每平方毫米 10 个）为 1.19±0.424，第二组为 1.64±0.534（p = 0.04）。C 组的两种标志物均高于 A 组或 B 组（p＜0.01）。
在 BA 中，BDP 比值是比 PCK7 更好的预后指标。
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