肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2011年
3期
145-149
,共5页
滕晓英%蔡毅然%郭蕾%苏勤
滕曉英%蔡毅然%郭蕾%囌勤
등효영%채의연%곽뢰%소근
癌,肝细胞%再生结节%变异肝细胞结节
癌,肝細胞%再生結節%變異肝細胞結節
암,간세포%재생결절%변이간세포결절
Carcinoma,hepatocellular%Regenerative nodule%Nodule of altered hepatocytes
目的 研究变异肝细胞结节(NAH)的形成和进展及其与肝细胞癌(HCC)的关系.方法 对HCC、来自癌周肝组织的NAH和普通再生结节(ORN)各50个进行组织学观察;通过免疫组织化学反应显示不同病变中乙型肝炎病毒(HBV)抗原表达水平,评价细胞增殖活性,检测p53蛋白异常积累.结果 在50例HCC切除标本的癌周肝组织中均检测到多个变异肝细胞病灶(FAH)和NAH,自FAH到HCC的演进过程中存在一系列连续的结构和形态变化;与ORN相比,NAH和HCC中HBV表面及核心抗原的表达水平逐渐降低[阳性率分别为70%(35/50)、50%(25/50)、10%(5/50)和60%(30/50)、40%(20/50)、6%(3/50)](P＜0.05),Ki-67抗原标记指数逐渐升高[分别为(0.58±0.49)%、(2.46±1.05)%和(40.36±26.27)%](P＜0.05),而p53蛋白异常积聚仅见于部分HCC[46%(23/50)],其程度随组织学分级的升高而增高[Ⅰ级、Ⅱ级和Ⅲ级病变中分别为13%(1/8)、41%(11/27)和73%(11/15)].结论 NAH在慢性乙型肝炎和肝硬变的切除标本中也可以检测到,有一系列的形态学改变可供识别,具有较高的增殖活性.NAH代表一种常见的HCC前期病变,可用于HCC发生的监测.
目的 研究變異肝細胞結節(NAH)的形成和進展及其與肝細胞癌(HCC)的關繫.方法 對HCC、來自癌週肝組織的NAH和普通再生結節(ORN)各50箇進行組織學觀察;通過免疫組織化學反應顯示不同病變中乙型肝炎病毒(HBV)抗原錶達水平,評價細胞增殖活性,檢測p53蛋白異常積纍.結果 在50例HCC切除標本的癌週肝組織中均檢測到多箇變異肝細胞病竈(FAH)和NAH,自FAH到HCC的縯進過程中存在一繫列連續的結構和形態變化;與ORN相比,NAH和HCC中HBV錶麵及覈心抗原的錶達水平逐漸降低[暘性率分彆為70%(35/50)、50%(25/50)、10%(5/50)和60%(30/50)、40%(20/50)、6%(3/50)](P＜0.05),Ki-67抗原標記指數逐漸升高[分彆為(0.58±0.49)%、(2.46±1.05)%和(40.36±26.27)%](P＜0.05),而p53蛋白異常積聚僅見于部分HCC[46%(23/50)],其程度隨組織學分級的升高而增高[Ⅰ級、Ⅱ級和Ⅲ級病變中分彆為13%(1/8)、41%(11/27)和73%(11/15)].結論 NAH在慢性乙型肝炎和肝硬變的切除標本中也可以檢測到,有一繫列的形態學改變可供識彆,具有較高的增殖活性.NAH代錶一種常見的HCC前期病變,可用于HCC髮生的鑑測.
목적 연구변이간세포결절(NAH)적형성화진전급기여간세포암(HCC)적관계.방법 대HCC、래자암주간조직적NAH화보통재생결절(ORN)각50개진행조직학관찰;통과면역조직화학반응현시불동병변중을형간염병독(HBV)항원표체수평,평개세포증식활성,검측p53단백이상적루.결과 재50례HCC절제표본적암주간조직중균검측도다개변이간세포병조(FAH)화NAH,자FAH도HCC적연진과정중존재일계렬련속적결구화형태변화;여ORN상비,NAH화HCC중HBV표면급핵심항원적표체수평축점강저[양성솔분별위70%(35/50)、50%(25/50)、10%(5/50)화60%(30/50)、40%(20/50)、6%(3/50)](P＜0.05),Ki-67항원표기지수축점승고[분별위(0.58±0.49)%、(2.46±1.05)%화(40.36±26.27)%](P＜0.05),이p53단백이상적취부견우부분HCC[46%(23/50)],기정도수조직학분급적승고이증고[Ⅰ급、Ⅱ급화Ⅲ급병변중분별위13%(1/8)、41%(11/27)화73%(11/15)].결론 NAH재만성을형간염화간경변적절제표본중야가이검측도,유일계렬적형태학개변가공식별,구유교고적증식활성.NAH대표일충상견적HCC전기병변,가용우HCC발생적감측.
Objective To describe the development of nodules of altered hepatocytes (NAH) in chronic hepatitis B and to reveal progression of the nodules to hepatocellular carcinoma (HCC). Methods HCC, NAH and ordinary regenerative nodules (ORN) were identified and compared histologically. Expression levels of hepatitis B virus (HBV) antigens, mitoactivity and p53 accumulation in these lesions were evaluated by immunohistochemistry. Results Multiple foci of altered hepatocytes (FAH) and NAH were identified in the liver parenchyma surrounding HCC in all of the samples examined. Sequential architectural and cellular changes were observed during the progression of FAH to NAH and HCC. Expression levels of HBV surface and core antigens were found to be significantly decreased in ORN, NAH and HCC, with their positive rates being 70 % (35/50), 50 % (25/50), 10 % (5/50) and 60 % (30/50), 40 % (20/50), 6 % (3/50), respectively (P ＜0.05). Ki-67-1abelling indices were determined to be (0.58±0.49) %, (2.46±1.05) % and (40.36±26.27) %in these lesions, respectively (P ＜0.05). Nuclear p53 accumulation was found only in HCC. Its occurrence was associated to a high histological grade, with its frequencies being 13 % (1/8), 41% (11/27) and 73 % (11/15)in grade 1, 2 and 3 lesions, respectively. Conclusion NAH lesions, identified by their morphologic features and mitoactivity elevation, are detectable in resected liver samples with chronic hepatitis B and cirrhosis. They represent a common HCC precursor and can be used as a surrogate marker for the surveillance of high-risk individuals.
