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Expression of vascular endothelial growth factor A in liver tissues of infants with biliary atresia
Alif Allam1, Mohammed El-Guindi1, Hatem Konsowa1
1National Liver Institute, Menoufia University, Shebin El-koom, Menoufia, Egypt.
Insights
Vascular endothelial growth factor A (VEGF-A) is highly expressed in infants with biliary atresia (BA). This finding, along with cytokeratin 7 (CK7) expression, aids in differentiating BA from other cholestatic conditions.
Area of Science:
- Pediatric Hepatology
- Gastroenterology
- Developmental Biology
Background:
- Biliary atresia (BA) is a severe neonatal cholestatic liver disease.
- Accurate diagnosis of BA is crucial for timely intervention and improved outcomes.
- VEGF-A and CK7 are potential biomarkers in liver diseases.
Purpose of the Study:
- To assess hepatic expression of vascular endothelial growth factor A (VEGF-A) in infants with BA.
- To evaluate the diagnostic accuracy of VEGF-A and cytokeratin 7 (CK7) in distinguishing BA from other causes of infantile cholestasis.
Main Methods:
- Retrospective study of 35 infants with BA and 38 infants with non-BA cholestasis.
- Immunohistochemical analysis of liver tissues for VEGF-A and CK7 expression.
- Diagnosis of BA confirmed by intraoperative cholangiography.
Main Results:
- Significantly higher VEGF-A expression in bile ducts (80%) and arterial walls (77.2%) in BA group compared to non-BA group (p < 0.0001).
- VEGF-A expression in portal structures showed high accuracy (84.9% for bile ducts, 82.19% for arterial walls) in differentiating BA.
- Elevated CK7 expression (grade II/III) was observed in the majority of BA patients, with >25% liver tissue expression having 80.8% accuracy.
Conclusions:
- Hepatic VEGF-A expression in portal structures is a valuable biomarker for diagnosing biliary atresia.
- Combined assessment of VEGF-A and CK7 expression enhances diagnostic accuracy for BA in infants.
- VEGF-A and CK7 show promise as diagnostic tools in pediatric liver diseases.
Aim Of The Study:
Assessment of hepatic expression of vascular endothelial growth factor A (VEGF-A) in liver tissues of infants with biliary atresia (BA).
Material And Methods:
This retrospective study included 35 infants with BA (BA group), and 38 infants with cholestasis due to causes other than BA (non-BA group). All patients had undergone full history taking, through clinical examination, routine investigations and immunostaining of liver tissue for VEGF-A and cytokeratin 7 (CK7). The diagnosis of BA was confirmed by intraoperative cholangiography. In the non-BA group, other specific laboratory tests according to the expected etiology were done.
Results:
Most of the BA group showed positive VEGF-A expression with variable degrees in both bile ducts (BDs; 80%), and arterial walls (AWs; 77.2%), while most of the non-BA group showed negative staining of VEGF in both BDs and AWs (89.5% and 86.8% respectively) (p < 0.0001). Positive VEGF expression in the portal structures in both BDs and AWs had 84.9% and 82.19% accuracy; respectively. The majority of BA group showed either grade II of positive cytokeratin-7 expression in liver tissues (45.7%) or grade III (34.3%), while most of the non-BA group showed grade I (71.1%) (p < 0.0001). Positive CK7 expression in > 25% of the liver tissues had 80.8% accuracy in discriminating between BA and non-BA.
Conclusions:
VEGF-A expression in the portal structures in liver tissues in both BDs and AWs had very good accuracy in discriminating between BA and non-BA patients.
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