CAJ | 학술논문

目的研究精氨酸酶(Arg)-1在肝细胞肝癌(HCC)和肝脏转移恶性肿瘤诊断和鉴别诊断中的意义,了解Arg-1在透明细胞型HCC和具有透明细胞形态肿瘤表达方式,以及Arg-1在其他类型肿瘤的表达情况.方法采用免疫组织化学EnVision法检测Arg-1在78例HCC(包括8例透明细胞型和70例非透明细胞型)和246例非肝脏来源肿瘤石蜡标本,包括肝脏转移恶性肿瘤29例(乳腺癌、鼻咽癌、内分泌癌等)、具有透明细胞形态的肿瘤77例(恶性黑色素瘤、肾透明细胞癌、腺泡软组织肉瘤等)、其他类型肿瘤140例(卵巢子宫内膜样癌、甲状腺乳头状癌、垂体瘤等)的表达.结果 (1)Arg-1在HCC细胞质和大部分细胞核呈棕黄色表达,在HCC总阳性率为96.2％(75/78),在高、中、低分化HCC阳性率分别为15/15、100％ (41/41)和86.4％(19/22).(2) Arg-1在78例HCC和29例肝脏转移恶性肿瘤阳性率分别为96.2％ (75/78)和0,Arg-1在HCC表达的敏感性、特异性、阳性预测值和阴性预测值分别为96.2％、100％、100％和90.6％.(3)Arg-1在透明细胞型HCC细胞核呈凝集状着色、胞膜呈线性着色；在77例具有透明细胞形态肿瘤的检测中,Arg-1总阳性率为14.3％ (11/77),其中有8/15恶性黑色素瘤表达,2/4卵巢透明细胞癌表达,在1/1胆囊腺癌伴透明细胞区表达,其余肿瘤中均不表达.Arg-1在恶性黑色素瘤和卵巢透明细胞癌细胞质着色深浅不一,呈浮云絮状,细胞核和细胞膜表达缺失；在胆囊腺癌伴透明细胞区表达方式与透明细胞型HCC一致.(4)检测140例其他类型肿瘤Arg-1的表达,结果显示Arg-1均为阴性.结论 Arg-1是HCC的一个敏感和特异性标志物,其在HCC细胞质和细胞核定位视为阳性结果.Arg-1在鉴别HCC和肝脏转移恶性肿瘤中具有很好的实用性,可以作为肝脏恶性肿瘤常规检测指标之一.
목적 연구정안산매(Arg)-1재간세포간암(HCC)화간장전이악성종류진단화감별진단중적의의,료해Arg-1재투명세포형HCC화구유투명세포형태종류표체방식,이급Arg-1재기타류형종류적표체정황.방법 채용면역조직화학EnVision법검측Arg-1재78례HCC(포괄8례투명세포형화70례비투명세포형)화246례비간장래원종류석사표본,포괄간장전이악성종류29례(유선암、비인암、내분비암등)、구유투명세포형태적종류77례(악성흑색소류、신투명세포암、선포연조직육류등)、기타류형종류140례(란소자궁내막양암、갑상선유두상암、수체류등)적표체.결과 (1)Arg-1재HCC세포질화대부분세포핵정종황색표체,재HCC총양성솔위96.2％(75/78),재고、중、저분화HCC양성솔분별위15/15、100％ (41/41)화86.4％(19/22).(2) Arg-1재78례HCC화29례간장전이악성종류양성솔분별위96.2％ (75/78)화0,Arg-1재HCC표체적민감성、특이성、양성예측치화음성예측치분별위96.2％、100％、100％화90.6％.(3)Arg-1재투명세포형HCC세포핵정응집상착색、포막정선성착색；재77례구유투명세포형태종류적검측중,Arg-1총양성솔위14.3％ (11/77),기중유8/15악성흑색소류표체,2/4란소투명세포암표체,재1/1담낭선암반투명세포구표체,기여종류중균불표체.Arg-1재악성흑색소류화란소투명세포암세포질착색심천불일,정부운서상,세포핵화세포막표체결실；재담낭선암반투명세포구표체방식여투명세포형HCC일치.(4)검측140례기타류형종류Arg-1적표체,결과현시Arg-1균위음성.결론 Arg-1시HCC적일개민감화특이성표지물,기재HCC세포질화세포핵정위시위양성결과.Arg-1재감별HCC화간장전이악성종류중구유흔호적실용성,가이작위간장악성종류상규검측지표지일.
Objective To study the role of arginase-1 (Arg-1) expression in differential diagnosis of hepatocellular carcinoma (HCC),Arg-1 staining pattern in clear cell neoplasm (HCC and non-HCC) and Arg-1 expression in non-hepatocellular tumors.Methods Seventy-eight cases of HCC (including 8 cases of clear cell type and 70 cases of non-clear cell type) and 246 cases of non-hepatocellular neoplasms (including 29 cases of metastatic tumors such as breast cancer,nasopharyngeal carcinoma and neuroendocrine carcinoma,77 cases of tumors with clear cell changes such as malignant melanoma,clear cell renal cell carcinoma and alveolar soft part sarcoma,and 140 cases of other types of tumors such as ovarian endometrioid adenocarcinoma,pituitary tumor and thyroid papillary carcinoma) were studied.Immunohistochemical study for Arg-1 was performed on the paraffin-embedded tumor tissue.Results In HCC,Arg-1 demonstrated both cytoplasmic and nuclear staining,with an overall sensitivity of 96.2％ (75/78).In well,moderately and poorly differentiated HCC,the sensitivity was 15/15,100％ (41/41)and 86.4％ (19/22),respectively.That was in contrast to negative staining for Arg-1 in all the 29 cases of metastatic tumors studied.The sensitivity,specificity,positive predictive value and negative predictive value of Arg-1 in distinguishing HCC from metastatic tumors was 96.2％,100％,100％ and 90.6％,respectively.Cytoplasmic and membranous staining was observed in clear cell type of HCC.The overall sensitivity of Arg-1 expression in the 77 cases of tumors with clear cell changes was 14.3％ (11/77),including 8/15 for malignant melanoma,2/4 for ovarian clear cell carcinoma and 1/1 gall bladder adenocarcinoma with clear cell component.In malignant melanoma and ovarian clear cell carcinoma,only cytoplasmic staining was demonstrated.There was no expression of Arg-1 in the 140 cases of other tumor types studied.Conclusions Arg-1 is a sensitive and specific marker for HCC.It is a potentially useful immunohistochemical marker in distinguishing HCC from metastatic tumors.Though also expressed in malignant melanoma and ovarian clear cell carcinoma,Arg-1 shows a different staining pattern as compared with that in HCC.