We investigated whether carbohydrate antigens on cholangitis, 2,4 in which the proliferated peribiliary biliary glycoproteins and carcinoembryonic antigen glands secrete large amounts of acid (sialylated and (CEA) are related to hepatolithiasis. CEA, ABO, and sulfated) or neutral mucin into the biliary lumen. 4 Most Lewis blood group-related antigens, as well as sialylintrahepatic calculi consist of calcium-bilirubinate Tn antigen in hepatic bile, were analyzed by Western (brown pigment) stones. 4,5 Bacterial infection, bile stablotting in samples from 12 patients with hepatolithiasis sis, and an alteration of the bile composition are and 37 with other biliary diseases (choledocholithiasis, thought to be responsible for the nucleation, formation, 13; cholecystolithiasis, 5; acute cholecystitis, 2; choland maturation of intrahepatic calculi. 6,7 In addition, angiocarcinoma, 5; common bile duct carcinoma, 4; panthe increased mucin production and secretion from the creatic carcinoma, 6; and metastatic carcinoma of liver, bile ducts may play an important role in the develop-2). CEA was positive on mucinous glycoprotein in six patients (50%) with hepatolithiasis and one case (17%) ment of intrahepatic calculi. 4,5,8 Biliary mucin, particuwith pancreatic carcinoma. CEA was also positive on a larly sulfated, reportedly promotes the formation of calglycoprotein of approximately 200 kd in eight patients cium-bilirubinate stones. 4,7 Histochemically, these (67%) with hepatolithiasis and two (33%) with pancreatic stones are composed of alternating multilayers of mucarcinoma. Lewis X was detected on the mucinous glycocin and pigment (calcium-bilirubinate) on their cut surprotein in almost all samples, as well as on glycoproteins face, suggesting that mucin bridges the pigment layers of approximately 180 kd in all hepatolithiasis samples and participates in the precipitation of calcium-biliruand approximately half of those from patients with other binate. 9
diseases. Sialyl-Tn antigen was detected on mucinous
Carbohydrate antigens of glycoproteins, glycolipids, glycoprotein in four (80%) with cholangiocarcinoma, two and proteoglycans play an important role in cell-to-(50%) with common bile duct carcinoma, and all pancreatic carcinoma samples. Mucinous glycoprotein and gly-cell adhesion and recognition [10][11][12][13] and also have a close coproteins containing CEA and Lewis X antigens are enrelationship with a specific bacterial infection. 14,15 Carriched in hepatic bile of hepatolithiasis, and they may be cinoembryonic antigen (CEA), which is widely used as closely related to the formation of intrahepatic calculi. a tumor marker, 16 also functions as an intercellular Sialyl-Tn antigen in biliary mucinous glycoprotein will adhesion molecule 17,18 and also binds and aggregates be a good marker of biliary and pancreatic carcinoma, bacteria. 19,20 Immunohistochemical studies [21][22][23] have and probably for cholangiocarcinoma complicated with disclosed that the biliary epithelial cells at different hepatolithiasis. (HEPATOLOGY 1996;23:258-263.) anatomic levels have a characteristic distribution of carbohydrate antigens, and their altered distribution Hepatolithiasis is quite common in the Far East, inis associated with biliary tract diseases. It is therefore cluding Japan, although it is extremely rare in Western likely that alterations of the carbohydrate residues of countries. [1][2][3] Histologically, the bile ducts containing mucin, as well as glycoproteins of bile, are related to stones show characteristically chronic proliferative the development of hepatolithiasis. However, there have been few detailed studies on the analysis of carbohydrate antigens of the biliary mucin and glycoprotein Abbreviations: CEA, carcinoembryonic antigen; SDS, sodium dodecyl sul-in human bile with respect to hepatobiliary diseases, fate; PBS, phosphate-buffered saline; Ig, immunoglobulin. particularly hepatolithiasis. [24][25][26] For example, several