Correlation analyses of ultrasonographic and histopathological characteristics of porta hepatis lymph nodes in biliary atresia.

Background: To perform correlation analyses between the ultrasonographic characteristics of porta hepatis lymph nodes (PHLNs) and the pathological features of PHLNs and the liver in biliary atresia (BA).

Methods: We analyzed the clinical ultrasonographic characteristics of PHLNs in 27 patients with BA, along with specific pathological features, including pathological size, the number of bile granules, the number of germinal centers, the proportion of lymphocytes, and the analysis of liver biopsy specimens. A series of correlation analyses were then performed between ultrasonography data, pathological features, and prognosis.

Results: The level of ultrasound echogenicity of PHLNs was positively correlated with the number of bile granules (r = 0.377, p = 0.004), while ultrasound and pathological size were also positively correlated with the number of germinal centers (r = 0.591, p = 0.001; r = 0.459, p = 0.016, respectively). No significant correlations were detected between the stage of liver fibrosis and pathological features or postoperative jaundice (all p > 0.05). Different types of lymphocytes proliferating in the livers, and CD8 + cells were positively correlated with the pathological size of PHLNs (r = 0.390, p = 0.045; r = 0.424, p = 0.028, respectively), and the number of germinal centers(r = 0.554, p = 0.003; r = 0.482, p = 0.011, respectively).The ultrasonographic and pathological size of PHLNs were only positively correlated with the serum levels of direct bilirubin(r = 0.431, p = 0.025; r = 0.593, p = 0.001, respectively).Finally, the pathological size of PHLNs and the number of CD8 + cells in the liver were negatively correlated with the reduction of jaundice following Kasai portoenterostomy (KPE) surgery (r=-0.385, p = 0.047; r=-0.567, p = 0.0411; r=-0.002, p = 0.033, respectively).

Conclusions: Analyses demonstrated that the ultrasonographic features of PHLNs are significantly correlated with pathological features of PHLNs and the liver. In addition, the enlargement of PHLNs might represent a prognostic predictor following KPE surgery.