Chronic hepatitis, of various etiologies, is a common worldwide disease that often results in a slowly progressive liver disease. Hepatitis C virus constitutes a major causative factor for chronic hepatitis, that led to a dramatic increase in the incidence of liver-related deaths due to hepatic decompensation, complications of cirrhosis and development of hepatocellular carcinoma .Adult stem cells in liver, termed oval cell or hepatic progenitor cells, are activated by liver injury as virus mediated injury. Upon such activation, they proliferate in singular and/or ductular forms.
The aim of this retrospectve study is immunohistochemial demonstration of stem cells in liver injury as chronic viral hepatitis and in hepatocellular carcinoma on top of cirrhosis, through their cytoplasmic expression of anticytokeratin 19 (anti CK19) regarding the morphology of stem cells, the change in number and distribution of stem cell in relation to the grade of chronic hepatitis activity and the stage of associated fibrosis and evaluation of stem cell as a predictor for liver disease severity or for hepatocellular carcinoma.
Oval cells were not observed in normal liver controls while were detected in both chronic hepatitis and HCC cases .This study demonstrated highly statistically significant positive correlations between the number of hepatic progenitors ,either in singular or ductular form, and the grade of chronic hepatitis, stage of fibrosis and the degree of steatosis. It was also observed that the number of hepatic progenitors increased significantly from cirrhosis without yet tumor development to cirrhosis adjacent to hepaocellular carcinoma (HCC), to be the maximum in HCC. Such associations between severity of liver disease and increase in the number of oval cells are consistent with the hypothesis that oval cell proliferation is associated with increased risk for development of hepatocellular carcinoma in chronic liver disease.
|
