Lee K T, Sheen P C, Liu Y E
Department of Surgery, Kaohsiung Medical College Hospital, Taiwan.
J Formos Med Assoc. 1998 Nov;97(11):788-90.
Although histologic studies of mucin distribution in the peribiliary glands have been conducted, a quantitative study of mucin content in intrahepatic bile ducts has yet to be reported. In an attempt to evaluate the mucin content in stone-containing intrahepatic bile ducts, we conducted a study on 25 surgically resected livers with hepatolithiasis. Specimens from 10 livers without stones served as controls. All specimens were fixed in 10% formalin and sectioned for periodic acid Schiffalcian blue double-stain (PAS-AB; pH 2.5) to evaluate the epithelial mucin content of the intrahepatic bile ducts. The PAS-AB positive area and the total epithelial area were measured with a computerized image analyzer and the PAS-AB index was calculated as the proportion of the PAS-AB positive to the total epithelial area. The histochemical study showed that epithelial cells in both the intramural glands and extramural glands of stone-containing intrahepatic bile ducts stained heavily and homogeneously with PAS-AB, while those of controls stained weakly. The PAS-AB indexes in stone-containing intrahepatic bile ducts were 51.8 +/- 15.88% for mucous cells of intramural glands, 52.86 +/- 9.85% for mucous cells of extramural glands, and 77.29 +/- 21.59% for serous cells of extramural glands. These values were all significantly higher than those of control specimens. However, the PAS-AB index of the epithelial lining in both hepatolithiasis and control specimens were similarly low, indicating the epithelial lining does not secrete much mucous glycoprotein. The results of this study led us to conclude that stone-containing intrahepatic bile ducts contain an abundant amount of mucous glycoprotein, and mucin is secreted from the peribiliary glands, not from the epithelial lining of the bile ducts.
尽管已经对胆管周围腺体中黏蛋白的分布进行了组织学研究,但肝内胆管中黏蛋白含量的定量研究尚未见报道。为了评估含结石的肝内胆管中的黏蛋白含量,我们对25例手术切除的肝内胆管结石症肝脏进行了研究。选取10例无结石的肝脏标本作为对照。所有标本均用10%福尔马林固定,切片后进行过碘酸希夫阿尔辛蓝双重染色(PAS-AB;pH 2.5),以评估肝内胆管上皮黏蛋白的含量。使用计算机图像分析仪测量PAS-AB阳性面积和总上皮面积,并计算PAS-AB指数,即PAS-AB阳性面积占总上皮面积的比例。组织化学研究表明,含结石的肝内胆管壁内腺体和壁外腺体的上皮细胞均被PAS-AB强烈且均匀地染色,而对照标本的上皮细胞染色较弱。含结石的肝内胆管中,壁内腺体黏液细胞的PAS-AB指数为51.8±15.88%,壁外腺体黏液细胞的PAS-AB指数为52.86±9.85%,壁外腺体浆液细胞的PAS-AB指数为77.29±21.59%。这些值均显著高于对照标本。然而,肝内胆管结石症和对照标本中胆管上皮衬里的PAS-AB指数同样较低,表明胆管上皮衬里分泌的黏液糖蛋白不多。本研究结果使我们得出结论,含结石的肝内胆管含有大量黏液糖蛋白,且黏蛋白是由胆管周围腺体分泌的,而非胆管上皮衬里分泌。