Department of Pathology, Malatya Education and Research Hospital, Malatya, Turkey.
Department of Histology and Embryology, Faculty of Medicine, İnönü University, Malatya, Turkey.
Indian J Pathol Microbiol. 2022 Jul-Sep;65(3):572-580. doi: 10.4103/ijpm.ijpm_1057_21.
Neonatal cholestasis is caused by a group of diseases that cause jaundice, which can be encountered in the neonatal period. Biliary atresia (BA) and idiopathic neonatal hepatitis (INH) are among neonatal cholestasis diseases.
The aim of this study was to perform histopathological and ultra-structural examinations of liver biopsy tissue samples from BA and INH patients with liver biopsies taken during laparotomy to confirm the diagnosis of biliary atresia.
A total of patients undergoing Kasai surgery before the age of 60 days were included in an "early" group (n = 7), whereas patients undergoing surgery after the age of 60 days were included in a "late" group (n = 11). The control group (n = 11) included INH patients.
For histopathological examinations, liver tissue samples obtained intra-operatively were subjected to routine histopathological procedures after being stained with caspase-3 and cytokeratin-7 antibodies. Ultra-structural evaluations were also performed. Statistical analysis used: For comparisons between the groups, a one-way analysis of variance (ANOVA) test and the Mann-Whitney U test were used for continuous variables.
Histopathological findings reflected the specific liver pathologic findings seen in biliary atresia. Although there was no significant difference between the BA groups, these parameters were not detected in the control group. The histopathological evaluations revealed no significant differences in the findings of liver parenchyma damage between the early, late, and control groups. Electron microscopic examinations showed that the patients in the late group had more severe signs of intra-cellular damage to the liver.
Although the histopathological examination revealed no significant differences in liver damage between the three groups, in ultra-structural evaluation, intra-cellular damage was found to be less in groups with better prognosis. Electron microscopy evaluations of intra-cellular damage may be more useful in this respect.
新生儿胆汁淤积症是一组引起黄疸的疾病，可在新生儿期发生。胆道闭锁（BA）和特发性新生儿肝炎（INH）是新生儿胆汁淤积症疾病之一。
本研究的目的是对剖腹术时进行肝活检的 BA 和 INH 患者的肝活检组织样本进行组织病理学和超微结构检查，以明确胆道闭锁的诊断。
总共纳入了 7 名在 60 天龄之前接受 Kasai 手术的患者（“早期”组），以及 11 名在 60 天龄之后接受手术的患者（“晚期”组）。对照组（n=11）包括 INH 患者。
对于组织病理学检查，术中获得的肝组织样本在经过 caspase-3 和细胞角蛋白-7 抗体染色后进行常规组织病理学程序。还进行了超微结构评估。统计分析采用：组间比较采用单因素方差分析（ANOVA）检验和曼-惠特尼 U 检验进行连续变量比较。
组织病理学发现反映了胆道闭锁的特定肝脏病理发现。虽然 BA 组之间没有显著差异，但在对照组中没有检测到这些参数。肝实质损伤的组织病理学评估结果显示，早期、晚期和对照组之间的肝损伤发现没有显著差异。电子显微镜检查显示，晚期组的肝细胞内损伤更严重。
尽管组织病理学检查显示三组之间的肝损伤没有显著差异，但在超微结构评估中，预后较好的组中发现细胞内损伤较轻。细胞内损伤的电子显微镜评估可能在这方面更有用。
