Hepatic expression of interferon-γ and CD68 in biliary atresia compared with other neonatal cholestatic disorders

Abstract

Objective 

The diagnosis of biliary atresia (BA) can be challenging as its histopathologic features overlap with those of other pediatric cholestatic liver diseases. We aimed to study the diagnostic value of hepatic interferon-γ (IFN-γ) and CD68 immunostaining in the differentiation of BA from other causes of neonatal cholestasis (NC).

Patients and methods 

Hepatic IFN-γ and CD68 immunostaining were investigated in 69 patients divided on the basis of the diagnosis into the BA group (n=34) and the non-BA group (n=35). The semiquantitative assessment included estimating the average of positive staining cells among inflammatory infiltrate in portal tracts of liver biopsy.

Results 

The mean hepatic CD68 and IFN-γ immunostaining in patients with BA was significantly higher (41.2±9.2 and 39.3±12.6, respectively) than that in the cholestasis group (20.8±15.2 and 21.5±15.7, respectively). The cutoff values were 24 for CD68 and 22 for IFN-γ to differentiate between BA and cholestatic patients, with a sensitivity and specificity of 94.18 and 74.30% for CD68 and 89 and 73.14% for IFN-γ, respectively.

Conclusion 

Both IFN-γ and CD68 immunostaining of the liver had a diagnostic value in differentiation between BA and other NC disorders and might be useful as an additional stain when investigating infants with NC.