The Prognostic Value of CD8⁺ and CD45RO⁺ T Cells Infiltration and Beclin1 Expression Levels for Early Postoperative Cholangitis of Biliary Atresia Patients after Kasai Operation

Abstract

Background: Postoperative cholangitis is a common but severe complication after Kasai portoenterostomy for biliary atresia (BA). This study aimed to identify its prognostic factors. Methods: Two sets of liver paraffin-embedded tissue samples were collected from BA patients who received Kasai portoenterostomy (n = 25 and n = 31, respectively). Patients were divided into non-cholangitis and cholangitis groups. The infiltration of CD4 + , CD8 + , CD45RO + , CD68 + cells and expression of Beclin1 were quantitatively evaluated in immunohistochemical analysis. Results: Cholangitis group had a significantly lower CD8 + T cell infiltration but a higher CD45RO + cell infiltration, and a lower Beclin1 level than non-cholangitis group (all P < 0.01). Multivariate logistic regression analysis indicated that infiltration of CD8 + cells (odds ratio [OR], 0.112; 95% confidence interval [CI], 0.022-0.577) and CD45RO + cells (OR, 3.88; 95% CI, 1.37-11.03), and Beclin1 level (OR, 0.088; 95% CI, 0.018-0.452) were independent influence factors for early postoperative cholangitis. Receiver operating characteristic (ROC) analysis showed that area under ROC curve (AUROC) values for CD8 + cells, CD45RO + cells and Beclin1 were 0.857, 0.738 and 0.900, respectively. Conclusion: Our findings demonstrated the CD8 + cells, CD45RO + cells and Beclin1 level possessed the prognostic value for early postoperative cholangitis following Kasai operation, which may be helpful to develop new prevention and treatment strategies for postoperative cholangitis.