中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2011年
4期
260-265
,共6页
卞银珠%姚登福%张崇国%李姗姗%吴玮%董志珍%邱历伟%蔚丹丹
卞銀珠%姚登福%張崇國%李姍姍%吳瑋%董誌珍%邱歷偉%蔚丹丹
변은주%요등복%장숭국%리산산%오위%동지진%구력위%위단단
癌,肝细胞%磷脂酰肌醇多聚糖%诊断%定量分析
癌,肝細胞%燐脂酰肌醇多聚糖%診斷%定量分析
암,간세포%린지선기순다취당%진단%정량분석
Carcinoma,hepatocellular%Phosphatidylinositol glycan%Diagnosis%Quantitative analysis
目的 研究磷脂酰肌醇蛋白聚糖-3(GPC-3)的表达特征及其在肝癌诊断与鉴别诊断中的临床价值.方法 制作鼠肝癌模型,并按病理组织检查结果分为正常组、肝细胞变性组(变性组)、癌前病变组(癌前组)和肝细胞癌组(癌变组).以Western blot和逆转录-聚合酶链反应分别观察GPC-3蛋白质及mRNA的动态表达;以自身配对法收集术后肝癌组织,根据其组织学类型分为肝癌组、癌旁组、远癌组,以免疫组织化学法分析GPC-3表达与病理学特征的关系;以酶联免疫吸附法定量分析肝病患者外周血GPC-3表达水平,并评价其诊断效率.多个样本均数比较用单因素方差分析,组间GPC-3的表达及病理学特征比较用单因素秩和检验,血清GPC-3比较用秩和检验,率的比较采用x2检验或Fisher's exact分析,以受试者工作特征曲线下面积比较GPC-3诊断肝癌的敏感性、特异性及诊断效率.结果 在鼠肝癌形成过程中,正常、变性、癌前和癌变组GPC-3阳性率分别为0(0/6)、83.3%(15/18)、100.0%(9/9)和100.0%(9/9).人肝癌组织GPC-3阳性呈棕黄色颗粒状染色,定位于胞质和细胞膜,肝癌、癌旁和远癌组的阳性率分别为80.6%、41.7%和0,肝癌组明显高于远癌组(x2=48.56,P＜0.01)和癌旁组(x2=11.455,P＜0.01);癌旁组明显高于远癌组(x2=18.94,P＜0.01).GPC-3表达与肿瘤分化程度和数目间未见明显相关,与瘤体大小有关(Z=2.941,P＜0.01).肝病患者血清GPC-3异常主要见于肝癌(52.8%,65/123),且在不同性别、年龄、甲胎蛋白水平、肿瘤数目、Child分级和肝外转移者间未见明显差异;但肝癌＜3.0cm组明显高于≥3.0cm组(x 2=6.318,P＜0.05); HBsAg阳性组明显高于阴性组(x 2=23.362,P＜0.01).GPC-3与甲胎蛋白(＞20 μg/L)联合诊断肝癌的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为87.00%、79.66%、82.17%、69.03%和92.16%.结论 GPC-3表达与肝癌密切相关,其表达的检测有助于肝癌早期诊断和鉴别诊断.
目的 研究燐脂酰肌醇蛋白聚糖-3(GPC-3)的錶達特徵及其在肝癌診斷與鑒彆診斷中的臨床價值.方法 製作鼠肝癌模型,併按病理組織檢查結果分為正常組、肝細胞變性組(變性組)、癌前病變組(癌前組)和肝細胞癌組(癌變組).以Western blot和逆轉錄-聚閤酶鏈反應分彆觀察GPC-3蛋白質及mRNA的動態錶達;以自身配對法收集術後肝癌組織,根據其組織學類型分為肝癌組、癌徬組、遠癌組,以免疫組織化學法分析GPC-3錶達與病理學特徵的關繫;以酶聯免疫吸附法定量分析肝病患者外週血GPC-3錶達水平,併評價其診斷效率.多箇樣本均數比較用單因素方差分析,組間GPC-3的錶達及病理學特徵比較用單因素秩和檢驗,血清GPC-3比較用秩和檢驗,率的比較採用x2檢驗或Fisher's exact分析,以受試者工作特徵麯線下麵積比較GPC-3診斷肝癌的敏感性、特異性及診斷效率.結果 在鼠肝癌形成過程中,正常、變性、癌前和癌變組GPC-3暘性率分彆為0(0/6)、83.3%(15/18)、100.0%(9/9)和100.0%(9/9).人肝癌組織GPC-3暘性呈棕黃色顆粒狀染色,定位于胞質和細胞膜,肝癌、癌徬和遠癌組的暘性率分彆為80.6%、41.7%和0,肝癌組明顯高于遠癌組(x2=48.56,P＜0.01)和癌徬組(x2=11.455,P＜0.01);癌徬組明顯高于遠癌組(x2=18.94,P＜0.01).GPC-3錶達與腫瘤分化程度和數目間未見明顯相關,與瘤體大小有關(Z=2.941,P＜0.01).肝病患者血清GPC-3異常主要見于肝癌(52.8%,65/123),且在不同性彆、年齡、甲胎蛋白水平、腫瘤數目、Child分級和肝外轉移者間未見明顯差異;但肝癌＜3.0cm組明顯高于≥3.0cm組(x 2=6.318,P＜0.05); HBsAg暘性組明顯高于陰性組(x 2=23.362,P＜0.01).GPC-3與甲胎蛋白(＞20 μg/L)聯閤診斷肝癌的敏感度、特異度、準確度、暘性預測值和陰性預測值分彆為87.00%、79.66%、82.17%、69.03%和92.16%.結論 GPC-3錶達與肝癌密切相關,其錶達的檢測有助于肝癌早期診斷和鑒彆診斷.
목적 연구린지선기순단백취당-3(GPC-3)적표체특정급기재간암진단여감별진단중적림상개치.방법 제작서간암모형,병안병리조직검사결과분위정상조、간세포변성조(변성조)、암전병변조(암전조)화간세포암조(암변조).이Western blot화역전록-취합매련반응분별관찰GPC-3단백질급mRNA적동태표체;이자신배대법수집술후간암조직,근거기조직학류형분위간암조、암방조、원암조,이면역조직화학법분석GPC-3표체여병이학특정적관계;이매련면역흡부법정량분석간병환자외주혈GPC-3표체수평,병평개기진단효솔.다개양본균수비교용단인소방차분석,조간GPC-3적표체급병이학특정비교용단인소질화검험,혈청GPC-3비교용질화검험,솔적비교채용x2검험혹Fisher's exact분석,이수시자공작특정곡선하면적비교GPC-3진단간암적민감성、특이성급진단효솔.결과 재서간암형성과정중,정상、변성、암전화암변조GPC-3양성솔분별위0(0/6)、83.3%(15/18)、100.0%(9/9)화100.0%(9/9).인간암조직GPC-3양성정종황색과립상염색,정위우포질화세포막,간암、암방화원암조적양성솔분별위80.6%、41.7%화0,간암조명현고우원암조(x2=48.56,P＜0.01)화암방조(x2=11.455,P＜0.01);암방조명현고우원암조(x2=18.94,P＜0.01).GPC-3표체여종류분화정도화수목간미견명현상관,여류체대소유관(Z=2.941,P＜0.01).간병환자혈청GPC-3이상주요견우간암(52.8%,65/123),차재불동성별、년령、갑태단백수평、종류수목、Child분급화간외전이자간미견명현차이;단간암＜3.0cm조명현고우≥3.0cm조(x 2=6.318,P＜0.05); HBsAg양성조명현고우음성조(x 2=23.362,P＜0.01).GPC-3여갑태단백(＞20 μg/L)연합진단간암적민감도、특이도、준학도、양성예측치화음성예측치분별위87.00%、79.66%、82.17%、69.03%화92.16%.결론 GPC-3표체여간암밀절상관,기표체적검측유조우간암조기진단화감별진단.
Objective To investigate the expression features of glypican-3 (GPC-3)and its diagnostic and differential values in hepatocellular carcinoma (HCC). Methods Rat hepatoma models were made and the dynamic expression features of GPC-3 protein and its gene were investigated by Western blotting and RT-PCR respectively. Liver specimens from 36 HCC patients were collected by self-control method and the expression and clinicopathological features of GPC-3 were analyzed by immunohistochemistry. Serum GPC-3 levels were quantitatively detected by ELISA and its efficiency for HCC diagnosis was evaluated in patients with liver diseases. Results The incidence of GPC-3 was 0% in control, 83.3% in degeneration, 100% in precanceration and 100% in canceration during dynamic formation of rat hepatoma, respectively. The positive GPC-3 was brown granule-like staining localized in membrane and cytoplasm in human HCC.The GPC-3 positive rates were 80.6% in HCC, 41.7% in surrounding tissues and none in distal tissues (P＜0.01), respectively. No positive relationship presented between GPC-3 and differentiation grade or the number of minor except of rumor size (Z=2.941, P＜0.01). The incidence of serum GPC-3 was 52.8% in HCC patients except of one patient with cirrhosis. No significant differences were found between GPC-3 and sex, age, AFP, mm or number, Child classification or extrahepatic metastasis except of rumor size (x2 = 6.318, P＜0.05) and HBV infection (x2 = 23.362,P＜0.01). Combined detection of GPC-3 and AFP could rise up diagnosis of HCC. Conclusions GPC-3 expression closely associated with HCC and might be useful for early diagnosis of HCC.
