| Background:Neonatal hepatitis and congenital biliary atresia are the primary pathogenies for the cholestasis jaundice in the infants.The two kinds of diseases have the similar symptom but the quite different prognosis. The cholestasis symptom for the congenital biliary atresia can be improved temporarily by the Kasai Procedure.But most of the cases will develop into the hepatocirrhosis and portal hypertention,and liver transplantation will be needed.At the same time,the neonatal hepatitis hes a good prognosis throuth the allopathy.In the recent research,it's thought that the different prognosis were associated with the different degree of fibrosis. The studies showed that the progressive fibrosis was the primary reason induced the bad prognosis of the congenital biliary atresia,and interruption even reverse of the hepatic fibrosis could improve it greatly.There was few reports about the hepatic fibrosis in the neonatal hepatitis.The hepatic fibrosis is a very complex pathology and physiology process,and the function of the cytokines were cared especially.Transforming growth factor-β1(IGFβ1) and connective tissue growth factor(CTGF)were the key cytokines in the hepatic fibrosis process.The two cytokines were studied widely.Objective:To observe the degrees of the hepatic fibrosis in neonatal hepatitis and congenital biliary atresia cases.To observe the the expression level and position of the cytokines TGF-β1 and CTGF in the two diseases, and the relation between the cytokions and diseases.To discuss the function of the TGF-β1,CTGF,and hepatic fibrosis in the congenital biliary atresia.Methods:Liver punctures were performed on 36 consenting cholestasis cases throuth the leading of echo.And 2 control samples were the normal liver tissue from the hepatoblastoma cases who underwent surgery.The cholestasis cases were divided into two groups according to the pathology and clinic results,the neonatal hepatitis group and the congenital biliary atresia group.The hematoxylin eosin(HE)dyeing and MASSON dyeing were done in all the samples and classified referring to the 2000 Xi'An criterion.The location and intensity of the expression of TGF-β1 and CTGF were also detected and observed immunohistochemically.Results:The degree of the hepatic fibrosis was severer in the congenital biliary atresia group than that in the neonatal hepatitis group,and there was significant difference(P＜0.01).And there was no fibrosis observed in the control group.In the neonatal hepatitis group,the expression of the TGF-β1 and CTGF were mainly in the hepatocytes,and less in the epithelium of the bile ducts.Both of the two cytokineswere detected in the hepatocyte and the epithelium of the bile ducts in the biliary atresia group(P＜0.01),but there was significant difference for the expression intensity between the two tissue(P＜0.01).The expression of TGFβ1 and CTGF in the biliary atresia group were obviously more intensive than that in the neonatal hepatitis group(P=0.000,0.000).The expression of the TGF-β1 and CTGF were increased in the liver tissue with the aggravation of the hepatic fibrosis(P＜0.01).Conclusions:There are hepatic fibrosis in the liver tissue from both the congenital biliary atresia and the neonatal hepatitis.And hepatic fibrosis in the cases with biliary atresia were severer than those in the cases with neonatal hepatitis.The expression of TGF-β1 and CTGF in the livers were closely related with the degrees of the hepatic fibrosis. There were different expressive intensity and tissue origins for the TGFβ1 and CTGF in the two diseases.The two cytokines were found in both the epithelium of the bile ducts and hepatocytes in the congenital biliary atresia,and there was more intensity in the epithelium,In the neonatal hepatitis,they were found mainly in the hepacytes,In the early phase,the expression of TGF-β1 and CTGF in the epithelium of the bile ducts could be associated with the pathogenisis of the congenital biliary atresia. |
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