CAJ | 학술논문

目的研究局灶性结节状增生(FNH)与变异肝细胞病灶(FAH)和结节(NAH)的关系,并对其微血管结构以及细胞增生活性与肝细胞腺瘤(HCA)进行对比观察.方法对5例患者的6个经典FNH和9例患者的10个HCA进行组织学观察,应用免疫组织化学方法检测CD_(34)、Ki-67抗原和细胞角蛋白19(CK19)表达,计算Ki-67标记指数以反映细胞增生活性.结果 6个FNH病变中均检测到多个FAH和NAH.HCA和FNH组织中均有CD_(34)标记的微血管,但其密度和分布不同.HCA中微血管弥漫存在;FNH中微血管呈灶性或小结节状分布,主要存在于NAH中.CK19标记显示,FNH中胆小管和胆管阳性,NAH和HCA均为阴性.FNH中,73个NAH的Ki-67标记指数(2.8%)明显高于FNH内NAH未累及的肝实质(0.6%),但与HCA(1.8%)相比差异无本统计学意义.结论经典FNH中常见NAH形成,NAH与周围肝实质不同.具有较高的细胞增殖活性以及类似于HCA的CD_(34)阳性微血管结构.
목적 연구국조성결절상증생(FNH)여변이간세포병조(FAH)화결절(NAH)적관계,병대기미혈관결구이급세포증생활성여간세포선류(HCA)진행대비관찰.방법 대5례환자적6개경전FNH화9례환자적10개HCA진행조직학관찰,응용면역조직화학방법검측CD_(34)、Ki-67항원화세포각단백19(CK19)표체,계산Ki-67표기지수이반영세포증생활성.결과 6개FNH병변중균검측도다개FAH화NAH.HCA화FNH조직중균유CD_(34)표기적미혈관,단기밀도화분포불동.HCA중미혈관미만존재;FNH중미혈관정조성혹소결절상분포,주요존재우NAH중.CK19표기현시,FNH중담소관화담관양성,NAH화HCA균위음성.FNH중,73개NAH적Ki-67표기지수(2.8%)명현고우FNH내NAH미루급적간실질(0.6%),단여HCA(1.8%)상비차이무본통계학의의.결론 경전FNH중상견NAH형성,NAH여주위간실질불동.구유교고적세포증식활성이급유사우HCA적CD_(34)양성미혈관결구.
Objective Focal nodular hyperplasia(FNH) is composed of multiple hyperplastic liver cell nodules,but its pathogenesis has not been elucidated. Foci (FAH) or nodules of altered hepatocytes (NAH) are precursors of hepatocellular adenoma (HCA) and carcinoma.This study aimed at identifying FAH and NAH from FNH and evaluating their role in FNH development.Methods 6 FNH lesions from 5 patients and 10 HCA from 9 patients were examined histologically,and expression levels of CD_(34) cytokeratin 19(CKl9) and Ki-67 antigen were demonstrated immunohistochemicailly.Proliferative activity was evaluated by Ki-67 antigen-labeling indices(Ki-67 LI).Results Multiple FAH and NAH were identified in all of the 6 FNH lesions. Whiie micmvasculatures were demonstrated by CD_(34) immunoreactivity in both HCA and FNH,their density and distribution were different in these two lesions,being diffuse in HCA and focal or nodular,mainly within NAH.CKl9 expression Was found in FNH,localized in ductal and ductular cells,but not within NAH and HCA.Average Ki.67 LI of 73 NAH(2.8%) was shown to be higher than that of the whole FNH lesions (0.6%),and had no statistieal difference comparable to that of HCA(1.8%).Conclusion Muhiple NAH are present in all classical FNH lesions.Unlike the surrounding parenchyma,NAH lesions are more proliferative and equipped with CD_(34)-positive microvasculatures as in HCA.