Expression of CD56 is Not Limited to Biliary Atresia and Correlates with the Degree of Fibrosis in Pediatric Cholestatic Diseases

Abstract

Backgrounds and Aims

CD56 immunostain is used as an adjunct to aid in the preoperative diagnosis of biliary atresia (BA) by liver biopsy. We aimed to study the expression of CD56 in different pediatric cholestatic diseases thereby evaluating its utility in the diagnosis of BA.

Methods

We performed immunohistochemistry for CD56 on 35 cases of pediatric cholestatic diseases and five age-matched controls. CD56 expression was assessed by a multiplication score (percentage positivity x intensity) in the biliary epithelium.

Results

The multiplication score between BA and choledochal cyst was not significantly different. High scores were also encountered in other cholestatic disorders. The score showed a significant negative association with serum albumin and a significant positive correlation with the serum ALT level. Very significant positive correlation between the score and portal fibrosis was obtained.

Conclusion

CD56 expression is an infidel marker for the histological diagnosis of BA and rather provides a clue to the disease status in pediatric cholestatic diseases.

Keywords:

• CD56
• Biliary atresia
• choledochal cyst
• pediatric cholestatic diseases
• fibrosis

Author contributorship statement

PA and SH collected and analyzed the data, and PA had prepared the first draft of the manuscript. SaM had provided the clinical data, and follow-up and reviewed the manuscript. SPu had performed the statistical analysis and reviewed the manuscript. SPa had critically reviewed the manuscript. SM had conceptualized the idea, was involved in the histological assessment of the cases and finalized the manuscript.

Ethical standards

This study was approved by the Institutional Ethical Committee IEC/AIIMS BBSR/STS/2019-20/06.