Expression of CTHRC1 in liver tissue and serum of patients with biliary atresia and its correlation with liver fibrosis
Zhang Fangfang , Wang Gang, Cui Mingyu, et al.
1.Department of Pediatric General Surgery, Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China; 2.Department of Pathology, Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
Abstract: Objective To investigate the differences in the expression of collagen triple helix repeat containing 1 (CTHRC1) in liver tissue and serum of children with biliary atresia (BA) and choledochal cyst (CC), and its correlation with the degree of hepatic fibrosis in children with BA. Methods This study retrospectively enrolled pediatric patients who underwent surgical treatment for BA with type Ⅲ (BA group) and CC (CC group) at the Department of Pediatric General Surgery, Provincial Hospital Affiliated to Shandong First Medical University from January 2021 to June 2024. According to the liver fibrosis stage (GS stage), children in the BA group were divided into the mild group (stage S1, S2) and the severe group (stage
S3, S4). Liver tissue paraffin sections and serum were obtained from each group. Clinical data including age at surgery, body weight at surgery, and preoperative laboratory parameters ［aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), total bilirubin (TBil), direct bilirubin (DBil), platelet count (PLT), and aspartate aminotransferase-to-platelet count ratio index (APRI)］ were collected. The expression of CTHRC1 in liver tissue was detected by immunohistochemical staining (IHC), and its correlation with the liver fibrosis degree in BA children was analyzed using Spearman method. The expression level of CTHRC1 in serum was detected by enzyme-linked immunosorbent assay (ELISA), and their correlations with GGT, TBil, and APRI were analyzed using Spearman method. Statistical analysis was performed by t-test and Mann-Whitney U test. Results Clinical data and liver tissue paraffin sections were obtained from 20 children with BA and 7 children with CC for IHC detection, including 13 cases in the mild group and 7 cases in the severe group. Additionally, clinical data and serum were obtained from another 10 children with BA and 8 children with CC for ELISA detection. The results of IHC detection showed that the CTHRC1 score in liver tissue of the BA group was significantly higher than that in the CC group (P<0.05), and significantly higher in the severe group than that in the mild group (P<0.05); the CTHRC1 score in liver tissue of children with BA was positively correlated with liver fibrosis degree (rs=0.790, P<0.001). The results of ELISA detection showed that the expression level of CTHRC1 in serum of the BA group was higher than that in the CC group (P<0.05). Conclusion The expression of CTHRC1 in liver tissue and serum of children with BA was enhanced, and the degree of expression in liver tissue was positively correlated with hepatic fibrosis degree, and CTHRC1 is expected to be a biological marker for the auxiliary diagnosis of BA.
2026, Vol. 14 
