CAJ | 학술논문

目的探讨磷脂酰肌醇蛋白聚糖3(GPC3)、甲胎蛋白(AFP)在肝细胞肝癌、肝内胆管细胞癌、结节性肝硬化的表达,并比较GPC3、AFP在肝细胞肝癌、肝内胆管细胞癌、结节性肝硬化中表达的差异.方法通过对50例原发性肝细胞肝癌、20例肝内胆管细胞癌、22例结节性肝硬化患者采用免疫组织化学方法进行GPC3、AFP检测,比较GPC3、AFP在肝细胞肝癌、肝内胆管细胞癌、结节性肝硬化中表达的差异.结果 GPC3在极早期+早期、中期+进展期肝细胞肝癌中的阳性率分别为82.4％、84.9％,均明显高于AFP的表达,差异有统计学意义(P＜0.05).GPC3和AFP两者联合检测可将诊断极早期+早期、中期+进展期肝细胞肝癌的敏感性提高为88.2％、87.8％.GPC3在高分化、中分化、低分化肝细胞肝癌中的阳性率分别为75.0％、85.0％、81.8％,均明显高于AFP蛋白的表达,差异有统计学意义(P＜0.05).GPC3和AFP两者联合检测可将诊断高分化、中分化、低分化肝细胞肝癌中的阳性率的敏感性提高为75.0％、90.0、90.9％.GPC3肝内胆管细胞癌各个分期相比,GPC3在极早期+早期、中期+进展期肝内胆管细胞癌中的阳性率分别为0％、6.25％,与AFP蛋白在肝内胆管细胞癌中的表达比较,差异未见统计学意义(P＞0.05).GPC3在高分化、中分化、低分化肝细胞肝癌中的阳性率分别为25.0％、0、0,与AFP蛋白在肝内胆管细胞癌中的表达,差异未见统计学意义(P＞0.05).结论 GPC3高表达于肝细胞肝癌组织中,对早期肝细胞肝癌诊断、区分良性及恶性早期占位性病变有重要提示作用.
목적 탐토린지선기순단백취당3(GPC3)、갑태단백(AFP)재간세포간암、간내담관세포암、결절성간경화적표체,병비교GPC3、AFP재간세포간암、간내담관세포암、결절성간경화중표체적차이.방법 통과대50례원발성간세포간암、20례간내담관세포암、22례결절성간경화환자채용면역조직화학방법진행GPC3、AFP검측,비교GPC3、AFP재간세포간암、간내담관세포암、결절성간경화중표체적차이.결과 GPC3재겁조기+조기、중기+진전기간세포간암중적양성솔분별위82.4％、84.9％,균명현고우AFP적표체,차이유통계학의의(P＜0.05).GPC3화AFP량자연합검측가장진단겁조기+조기、중기+진전기간세포간암적민감성제고위88.2％、87.8％.GPC3재고분화、중분화、저분화간세포간암중적양성솔분별위75.0％、85.0％、81.8％,균명현고우AFP단백적표체,차이유통계학의의(P＜0.05).GPC3화AFP량자연합검측가장진단고분화、중분화、저분화간세포간암중적양성솔적민감성제고위75.0％、90.0、90.9％.GPC3간내담관세포암각개분기상비,GPC3재겁조기+조기、중기+진전기간내담관세포암중적양성솔분별위0％、6.25％,여AFP단백재간내담관세포암중적표체비교,차이미견통계학의의(P＞0.05).GPC3재고분화、중분화、저분화간세포간암중적양성솔분별위25.0％、0、0,여AFP단백재간내담관세포암중적표체,차이미견통계학의의(P＞0.05).결론 GPC3고표체우간세포간암조직중,대조기간세포간암진단、구분량성급악성조기점위성병변유중요제시작용.
Objective To investigate the expression of GPC3 and AFP in hepatocellular carcinoma,intrahepatic cholangiocarcinoma,cirrhosis,and to compare the differences of expression of GPC3 and AFP in hepatocellular carcinoma,intrahepatic cholangiocarcinoma,nodular cirrhosis.Methods GPC3 and AFP levels were detected by immunohistochemistry method in 50 cases of primary hepatocellular carcinoma,20 cases of intrahepatic cholangiocarcinoma and 22 cases of nodular cirrhosis.The differences of expression of GPC3 and AFP in hepatocellular carcinoma,intrahepatic cholangiocarcinoma and nodular cirrhosis were compared.Results The positive rate of GPC3 in the very early and early,interim and advanced hepatocellular carcinoma was 82.4％,84.9％ respectively,they were significantly higher than the expressions of AFP protein,the differences were statistically significant (P ＜ 0.05).The sensitivity of combined detection of GPC3 and AFP in very early and early,interim and advanced stage of hepatocellular carcinoma increased to 88.2％,87.8％ respectively.The positive rate of GPC3 in high differentiation,differentiation,poorly differentiated hepatocellular carcinoma were 75.0％,85.0％,81.8％,they were significantly higher than the expression of AFP protein,the differences were statistically significant (P ＜ 0.05).The positive rate sensitivity of combined detection of GPC3 and AFP increased to 75.％,90.0％,90.9％ in diagnosis of high differentiation,differentiation,poorly differentiated hepatocellular carcinoma.Compared with each stage of intrahepatic cholangiocarcinoma,the positive rate of GPC3 in the very early and early period,interim and advanced stage was 0,6.25 ％ respectively,there were no significant differences compared with the expression of AFP protein in intrahepatic cholangiocarcinoma(P ＞ 0.05).The positive rate of GPC3 in high differentiation,differentiation,poorly differentiated intrahepatic cholangiocarcinoma were 25％,0,0,and there were no significant differences compared with the expression of AFP protein in intrahepatic cholangiocarcinoma (P ＞ 0.05).Conclusions The high expression of GPC3 in hepatocellular carcinoma tissues play an important role in early diagnosis of hepatocellular carcinoma and distinguishing between benign and malignant early lesions.