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World J Gastroenterol. Mar 7, 2006; 12(9): 1443-1446
Published online Mar 7, 2006. doi: 10.3748/wjg.v12.i9.1443
Ductular proliferation in liver tissues with severe chronic hepatitis B: An immunohistochemical study
Yao-Kai Chen, Xu-Xia Zhao, Jun-Gang Li, Song Lang, Yu-Ming Wang
Yao-Kai Chen, Jun-Gang Li, Song Lang, Yu-Ming Wang, Institute of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
Xu-Xia Zhao, Department of Hepatology, Gucheng People’s Hospital, Gucheng 443003, Hubei Province, China
Supported by the National Natural Science Foundation of China, No. 30370391
Correspondence to: Dr. Yao-Kai Chen, Institute of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing 400038, China. yaokaichen@hotmail.com
Telephone: +86-2368754475-8006 Fax: +86-2365461319
Received: June 24, 2005
Revised: August 1, 2005
Accepted: September 10, 2005
Published online: March 7, 2006

AIM: To clarify the pathogenesis of ductular proliferation and its possible association with oval cell activation and hepatocyte regeneration.

METHODS: Immunohistochemical staining and image analysis of the ductular structures in the liver tissues from 11 patients with severe chronic hepatitis B and 2 healthy individuals were performed. The liver specimens were sectioned serially, and then cytokeratin 8 (CK8), CK19, OV6, proliferating cell nuclear antigens (PCNA), glutathione-S-transferase (GST), α-fetal protein (AFP) and albumin were stained immunohistochemically.

RESULTS: Typical and atypical types of ductular proliferation were observed in the portal tracts of the liver tissues in all 11 patients. The proliferating ductular cells were positive for CK8, CK19, OV6 and PCNA staining. Some atypical ductular cells displayed the morphological and immunohistochemical characteristics of hepatic oval cells. Some small hepatocyte-like cells were between hepatic oval cells and mature hepatocytes morphometrically and immunohistochemically.

CONCLUSION: The proliferating ductules in the liver of patients with severe chronic liver disease may have different origins. Some atypical ductular cells are actually activated hepatic oval cells. Atypical ductular proliferation is related to hepatocyte regeneration and small hepatocyte-like cells may be intermediate transient cells between hepatic oval cells and mature hepatocytes.

Keywords: Ductular proliferation, Chronic hepatitis B, Hepatocyte regeneration