glycogen and Hepatoblastoma

Indications for liver biopsy in children are often specific to this age group, especially in young children for the diagnosis of cholestasis. Since liver biopsies are quite unfrequent in the children population and concern rare but various diseases, it is recommended to entrust the analysis to a specialized liver pathologist, in a laboratory where cryoconservation, specific immuno-stainings, enzymatic studies, and electron microscopy can be performed. Histology is complementary to other methods for the diagnosis, and is valuable for the evaluation of the prognosis, especially the staging of fibrosis and the grading of inflammatory diseases. In cases of co-morbidity or difficult differential diagnosis, histology can also be of great value. For metabolic disorders, the liver tissue can also be used for enzyme detection or evaluation of iron or copper overload. Biopsy is also a key element in the management after liver transplantation. The microscopic images shown here are representative of the most frequent liver diseases in childhood and illustrate the data outlined during the conference.

Topics: Biliary Tract; Biliary Tract Diseases; Biopsy; Child; Glycogen; Hamartoma; Hepatoblastoma; Hepatocytes; Humans; Hyperplasia; Liver; Liver Diseases; Metabolism, Inborn Errors

To evaluate Bcl-xL, Bax, PCNA, cytokeratin 19 (CK-19), glycogen content and DNA ploidy expression in hepatoblastoma (HB) and their prognostic value.. This retrospective study on 26 cases of HB involved DNA ploidy estimations separately for various subtypes on histological sections using image cytometry of Feulgen-stained smears. Glycogen content, PCNA, CK-19, Bax and Bcl-xL expression on tissue sections were evaluated. THE outcome on follow-up (mean 86 months) and Kaplan-Meier survival analysis were performed.. Fetal areas were diploid (84%); embryonal areas were aneuploid (89.47%) (p < 0.001). PCNA labeling index was low in fetal (10.82%) and high in embryonal areas (59.85%) (p = 0.03). CK-19 was negative in fetal, but focally positive in embryonal areas. Bax was negative in fetal (80%) and positive in embryonal areas (88.23%) (p < 0.001); Bcl-xL was more frequently positive in fetal (90%) than embryonal areas (52.94%) (p = 0.02). Fetal cells were rich in glycogen. Kaplan-Meier survival analysis showed good initial radiological response to chemotherapy (p = 0.009), glycogen content (p = 0.0137) and DNA diploid cases (p = 0.0429) were associated with good outcome on univariate analysis. Histology typing (p = 0.085), Bcl-xL (p = 0.689), Bax (p = 0.27), CK-19 (p = 0.281), PCNA (p = 0.689), age (p = 0.24), sex (p = 0.5661), stage (p = 0.24) and α-fetoprotein levels (p = 0.49) were unrelated to outcome. Multivariate analysis showed glycogen content to be the most statistically significant variable (0.024).. Fetal and embryonal areas show different staining patterns for PCNA, Bax and Bcl-xL. DNA ploidy and glycogen content are significant prognostic variables.

Topics: Adolescent; bcl-2-Associated X Protein; bcl-X Protein; Biomarkers, Tumor; Cell Proliferation; Child; Child, Preschool; Female; Glycogen; Hepatoblastoma; Humans; Infant; Keratin-19; Liver Neoplasms; Male; Multivariate Analysis; Periodic Acid-Schiff Reaction; Ploidies; Prognosis; Proliferating Cell Nuclear Antigen; Proportional Hazards Models; Retrospective Studies; Survival Analysis