Panicha Tangtrongchitr1, Sopee Poomsawat2, Voranush Chongsrisawat3, Sittisak Honsawek4, Yong Poovorawan3, Yuda Chongpison5, Paisarn Vejchapipat6. 1. Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 2. Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand. 3. Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 4. Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 5. Biostatistics Division, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 6. Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. paisarnv@gmail.com.
Abstract
BACKGROUND: The prognosis of biliary atresia (BA) remains difficult to predict. This study evaluated the roles of hepatocyte growth factor (HGF) and its receptor (C-met) towards clinical outcome and native liver survival. METHODS: Hepatic HGF and C-met expression were determined using immunohistochemistry from liver biopsies of 41 BA patients during Kasai operation, and 17 non-cholestatic patients. The HGF and C-met expression was visually scored as per its intensity and percentage of stained area. BA patients were classified as high- and low-HGF and C-met receptor status. Native liver survival was compared between the two groups at 3-year follow-up. Data are shown as median and range. MAIN RESULTS: Median age of BA patients was 2 (1-6) months. Hepatic HGF and C-met staining scores of BA patients were higher than those of non-cholestatic patients (P < 0.0001). There was a correlation between HGF and C-met staining scores (spearman r = 0.77, P < 0.0001). However, there was no association between their expression and early outcome at 6 months post-op. Mean follow-up time was 68.6 months. Survival analysis revealed that native liver survival at 1 year and 3 years were 88% and 77%, respectively. Additionally, 82.6% (19/23) of patients in the low-HGF group survived with native liver, compared with 66.7% (10/15) of those in high-HGF group (P = 0.436). For C-met expression, 78.6% (22/28) of low-score and 70% (7/10) of high score groups survived with native liver (P = 0.673). CONCLUSIONS: Strong expression of hepatic HGF and its receptor in BA patients was demonstrated. However, the expression was not associated with the early outcome and native liver survival. These results suggest that HGF involved in the liver pathology of BA but its expression cannot be used as a prognostic indicator. Small sample size of patients was a main limitation. Further studies are warranted to validate our findings.
BACKGROUND: The prognosis of biliary atresia (BA) remains difficult to predict. This study evaluated the roles of hepatocyte growth factor (HGF) and its receptor (C-met) towards clinical outcome and native liver survival. METHODS: Hepatic HGF and C-met expression were determined using immunohistochemistry from liver biopsies of 41 BApatients during Kasai operation, and 17 non-cholestaticpatients. The HGF and C-met expression was visually scored as per its intensity and percentage of stained area. BApatients were classified as high- and low-HGF and C-met receptor status. Native liver survival was compared between the two groups at 3-year follow-up. Data are shown as median and range. MAIN RESULTS: Median age of BApatients was 2 (1-6) months. Hepatic HGF and C-met staining scores of BApatients were higher than those of non-cholestaticpatients (P < 0.0001). There was a correlation between HGF and C-met staining scores (spearman r = 0.77, P < 0.0001). However, there was no association between their expression and early outcome at 6 months post-op. Mean follow-up time was 68.6 months. Survival analysis revealed that native liver survival at 1 year and 3 years were 88% and 77%, respectively. Additionally, 82.6% (19/23) of patients in the low-HGF group survived with native liver, compared with 66.7% (10/15) of those in high-HGF group (P = 0.436). For C-met expression, 78.6% (22/28) of low-score and 70% (7/10) of high score groups survived with native liver (P = 0.673). CONCLUSIONS: Strong expression of hepatic HGF and its receptor in BApatients was demonstrated. However, the expression was not associated with the early outcome and native liver survival. These results suggest that HGF involved in the liver pathology of BA but its expression cannot be used as a prognostic indicator. Small sample size of patients was a main limitation. Further studies are warranted to validate our findings.
Authors: W R Kim; J R Lake; J M Smith; M A Skeans; D P Schladt; E B Edwards; A M Harper; J L Wainright; J J Snyder; A K Israni; B L Kasiske Journal: Am J Transplant Date: 2016-01 Impact factor: 8.086