Department of Pediatric Surgery, Ibaraki Children's Hospital, Ibaraki, Japan.
Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 3-3-13 Hongo, Bunkyo-Ku, Tokyo, Japan.
BMC Gastroenterol. 2024 Aug 15;24(1):266. doi: 10.1186/s12876-024-03370-0.
Lymphatic vessels (LVs) play a crucial role in immune reactions by serving as the principal conduits for immune cells. However, to date, no study has analyzed the morphological changes in the LVs of patients with biliary atresia (BA). In this study, we aimed to determine the morphological changes in the LVs irrigating the liver in patients with BA, elucidate their correlations with the morphology of the portal vein (PV) branches, and discuss their etiopathogenetic significance.
Morphometric analyses of liver biopsy specimens from patients treated between 1986 and 2016 were performed. The parameters measured were as follows: the whole liver area of the specimen, fibrotic area, number of LVs, LVs without patent lumen (designated as Ly0) and PV branches, and diameters of the LVs with patent lumen and the PVs.
The numbers of LVs, Ly0, and PV branches per unit area of the whole liver specimen were significantly higher in patients with BA than in control participants with liver disease and those with normal livers. However, no correlation was observed between the fibrotic area and the average diameter of LVs or PVs, and between the fibrotic area and the number of LVs or PV branches. Furthermore, no correlation was observed between the total number of LVs and the number of PV branches.
The present study showed a significant increase in the number of total LVs and Ly0, characterized by a high Ly0 to total LVs ratio, suggesting that lymphangiogenesis occurs in the liver of patients with BA.
淋巴管 (LVs) 通过作为免疫细胞的主要通道，在免疫反应中起着至关重要的作用。然而，迄今为止，尚无研究分析过胆道闭锁 (BA) 患者的 LVs 的形态变化。在这项研究中，我们旨在确定 BA 患者肝脏中 LV 的形态变化，阐明其与门静脉 (PV) 分支形态的相关性，并讨论其发病机制意义。
对 1986 年至 2016 年间治疗的患者的肝活检标本进行形态计量学分析。测量的参数如下：标本的整个肝区面积、纤维化面积、LV 数量、无通畅管腔的 LV（指定为 Ly0）和 PV 分支以及有通畅管腔的 LV 和 PV 的直径。
BA 患者的 LV、Ly0 和 PV 分支数量/整个肝标本面积均显著高于肝病对照组和正常对照组。然而，LV 或 PV 的平均直径与纤维化面积之间，以及 LV 或 PV 分支数量与纤维化面积之间均无相关性。此外，LV 总数与 PV 分支数量之间也无相关性。
本研究显示 BA 患者肝脏的总 LV 和 Ly0 数量显著增加，其 Ly0 与总 LV 的比值较高，提示淋巴生成发生在 BA 患者的肝脏中。
