磷脂酰肌醇蛋白聚糖3等抗体在高分化肝细胞肝癌中的表达及其鉴别诊断意义
린지선기순단백취당3등항체재고분화간세포간암중적표체급기감별진단의의
Expression and clinicopathologic significance of GPC3 and other antibodies in well-differentiated hepatocellular carcinoma
  • 万方数据
    中华病理学杂志 중화병이학잡지
    Chinese Journal of Pathology
    2011年 1期 11-16 ,共6页

    杜经丽%韦立新%王玉兰

    두경려%위립신%왕옥란

    肝肿瘤%癌,肝细胞%腺瘤,肝细胞 肝腫瘤%癌,肝細胞%腺瘤,肝細胞
    간종류%암,간세포%선류,간세포
    Liver neoplasms%Carcinoma,hepatocellular%Adenoma,liver cell
    目的 探讨磷脂酰肌醇蛋白聚糖3(GPC3)、CD10、CD34及甲胎蛋白(AFP)在高分化肝细胞肝癌(HCC)、高级别异型增生性结节(H-DN)、低级别异型增生性结节(L-DN)、肝硬化结节、局灶性结节状增生(FNH)和肝腺瘤中的表达及临床应用价值.方法 应用免疫组织化学(EliVision法)对80例HCC(30例高分化HCC、50例进展期HCC)、30例DN(18例H-DN、12例L-DN)、36例肝硬化结节、20例FNH及20例肝腺瘤分别进行GPC3、CD10、CD34及AFP抗体标记,分析这些抗体在肝结节性病变中的鉴别诊断价值.结果 (1)GPC3的阳性表达率在进展期HCC中为92%(46/50),在高分化HCC中为66.7%(20/30),在H-DN中为2/18,在L-DN、肝硬化结节、FNH和肝腺瘤中无表达.GPC3在高分化HCC中的阳性表达率低于进展期HCC,而高于H-DN、L-DN、肝硬化结节、FNH、肝腺瘤,表达差异有统计学意义(P＜0.05).(2)CD10在进展期HCC中的失表达率为78%(39/50),阳性细胞比率＞50%的仅为2%(1/50);在高分化HCC中失表达率为43.3%(13/30),阳性细胞比率＞50%的为16.7%(5/30),而在H-DN、L-DN、肝硬化结节中失表达率分别为0、0、2.8%(1/36),阳性细胞比率＞50%分别为15/18、11/12、80.6%(29/36);在FNH和肝腺瘤中失表达率均为20%(4/20),阳性细胞比率＞50%均为60%(12/20).CD10在高分化HCC中的阳性细胞比率高于进展期HCC,而低于在H-DN、L-DN、肝硬化结节、FNH和肝腺瘤中的表达,表达差异有统计学意义(P＜0.05).(3)GD34在进展期HCC、高分化HCC中的表达范围绝大部分在25%～100%,阳性细胞数＞50%的为76.0%(38/50)和70.0%(21/30);而在H-DN和L-DN中的表达范围多集中在5%～25%,阳性细胞数＜25%的分别为16/18、10/12;在肝硬化结节表达范围在0～5%,阳性细胞数＜25%的为27.8%(10/36).在FNH与肝腺瘤中的表达范围在25%～50%.CD34在高分化HCC中的阳性细胞数与进展期HCC中无明显差异(P＞0.05),但高于H-DN、L-DN、肝硬化结节、FNH和肝腺瘤中的阳性细胞数,差异有统计学意义(P＜0.05).(4)AFP在高分化HCC中阳性表达率为20%(6/30),在进展期HGG中阳性表达率为44%(22/50),在H-DN、L-DN、肝硬化结节、FNH和肝腺瘤中均未见表达.AFP在高分化HCC中的阳性表达率低于进展期HCC,而高于肝硬化结节、FNH和肝腺瘤,差异具有统计学意义(P＜0.05).结论 GPG3、CD10、CD34及AFP在高分化HCC的诊断与鉴别诊断中,GPC3是一个较敏感及特异的标记物,其与CD34、CD10及AFP联合使用对诊断高分化HCC以及鉴别其与DN、FNH、肝腺瘤、肝硬化结节具有较高的应用价值.
    목적 탐토린지선기순단백취당3(GPC3)、CD10、CD34급갑태단백(AFP)재고분화간세포간암(HCC)、고급별이형증생성결절(H-DN)、저급별이형증생성결절(L-DN)、간경화결절、국조성결절상증생(FNH)화간선류중적표체급림상응용개치.방법 응용면역조직화학(EliVision법)대80례HCC(30례고분화HCC、50례진전기HCC)、30례DN(18례H-DN、12례L-DN)、36례간경화결절、20례FNH급20례간선류분별진행GPC3、CD10、CD34급AFP항체표기,분석저사항체재간결절성병변중적감별진단개치.결과 (1)GPC3적양성표체솔재진전기HCC중위92%(46/50),재고분화HCC중위66.7%(20/30),재H-DN중위2/18,재L-DN、간경화결절、FNH화간선류중무표체.GPC3재고분화HCC중적양성표체솔저우진전기HCC,이고우H-DN、L-DN、간경화결절、FNH、간선류,표체차이유통계학의의(P＜0.05).(2)CD10재진전기HCC중적실표체솔위78%(39/50),양성세포비솔＞50%적부위2%(1/50);재고분화HCC중실표체솔위43.3%(13/30),양성세포비솔＞50%적위16.7%(5/30),이재H-DN、L-DN、간경화결절중실표체솔분별위0、0、2.8%(1/36),양성세포비솔＞50%분별위15/18、11/12、80.6%(29/36);재FNH화간선류중실표체솔균위20%(4/20),양성세포비솔＞50%균위60%(12/20).CD10재고분화HCC중적양성세포비솔고우진전기HCC,이저우재H-DN、L-DN、간경화결절、FNH화간선류중적표체,표체차이유통계학의의(P＜0.05).(3)GD34재진전기HCC、고분화HCC중적표체범위절대부분재25%～100%,양성세포수＞50%적위76.0%(38/50)화70.0%(21/30);이재H-DN화L-DN중적표체범위다집중재5%～25%,양성세포수＜25%적분별위16/18、10/12;재간경화결절표체범위재0～5%,양성세포수＜25%적위27.8%(10/36).재FNH여간선류중적표체범위재25%～50%.CD34재고분화HCC중적양성세포수여진전기HCC중무명현차이(P＞0.05),단고우H-DN、L-DN、간경화결절、FNH화간선류중적양성세포수,차이유통계학의의(P＜0.05).(4)AFP재고분화HCC중양성표체솔위20%(6/30),재진전기HGG중양성표체솔위44%(22/50),재H-DN、L-DN、간경화결절、FNH화간선류중균미견표체.AFP재고분화HCC중적양성표체솔저우진전기HCC,이고우간경화결절、FNH화간선류,차이구유통계학의의(P＜0.05).결론 GPG3、CD10、CD34급AFP재고분화HCC적진단여감별진단중,GPC3시일개교민감급특이적표기물,기여CD34、CD10급AFP연합사용대진단고분화HCC이급감별기여DN、FNH、간선류、간경화결절구유교고적응용개치.
    Objective To study the expression and significance of GPC3, CD10 and CD34 in hepatocellular carcinoma (HCC), dysplastic nodules ( DN), cirrhotic regenerative nodules (CRN), focal nodular hyperplasia (FNH) and hepatocellular adenoma (HA). Methods Immunohistocheicical study for GPC3, CD10,CD34 and AFP was performed on 80 cases of HCC (30 cases of well-differentiated HCC and 50 cases of advanced HCC), 30 cases of DN (18 cases of high-grade DN and 12 cases of low-grade DN),36 cases of CRN, 20 cases of FNH and 20 cases of HA. Results (1)The positive expression rate of GPC3was 92% (46/50) in advanced HCC, 66. 7% (20/30) in well-differentiated HCC, 2/18 in high-grade DN, and 0 in low-grade DN, CRN, FNH and HA. The expression rate of GPC3 in well-differentiated HCC was lower than that in advanced HCC and higher than that in high-grade DN (P＜0.05). (2) The negative expression rate of CD10 was 78%(39/50) in advanced HCC, 43.3% (13/30) in well-differentiated HCC,20% (4/20 and 4/20) in both FNH and HA, 2.8% (1/36) in CRN and 0 in both high-grade DN and low-grade DN. The occurrence of CD10-strongly positive cells was 2%(1/50) in advanced HCC, 16.7%(5/30) in well-differentiated HCC, 15/18 in high-grade DN, 11/12 in low-grade DN, 80.6% (29/36) in CRN and 60%(12/20 and 12/20) in both FNH and HA. The positive expression rate of CD10 in well-differentiated HCC was higher than that in advanced HCC and lower than that in high-grade DN,low-grade DN, CRN, FNH and HA(P＜0.05).(3) The positive expression rates of CD34 in advanced HCC and well-differentiated HCC ranged from 25% to 100% [and strongly positive in 76% (38/50) and 70%(21/30), respectively]. The rates in high-grade DN and low-grade DN ranged from 5% to 25% (and weakly positive in 16/18 and 10/12, respectively). In CRN, the rate ranged from 0 to 5% [and weakly positive in 27.8%(10/36)]. In FNH and HA, the positive rates ranged from 25% to 50%. The positive expression rate of CD34 in well-differentiated HCC was significantly higher than that in high-grade DN,low-grade DN, CRN, FNH and HA (P＜0.05). (4) The positive expression rate of AFP was 44%(22/50) in advanced HCC, 20% (6/30) in well-differentiated HCC, no expression in DN, LCN, LCN,FNH and HA. The positive expression rate of AFP in well-differentiated HCC was lower than that in advanced HCC and higher than that in LCN, FNH and HA. The different expression had statistical significance (P＜0.05). Conclusions GPC3 is a relatively sensitive and specific marker in pathologic diagnosis of HCC. When coupled with immunohistochemical results of CD34, CD10 and AFP, GPC3 is useful in differentiating HCC from DN, LCN, FNH and HA.
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