联合应用磷脂酰肌醇蛋白多糖-3(GPC-3)和细胞角蛋白-19(CK-19)免疫组化检测在肝细胞肝癌诊断和鉴别诊断中的价值

doi:10.3969/j.issn.1006-7795.2011.05.014

首都医科大学学报 ›› 2011, Vol. 32 ›› Issue (5): 653-657.doi: 10.3969/j.issn.1006-7795.2011.05.014

联合应用磷脂酰肌醇蛋白多糖-3(GPC-3)和细胞角蛋白-19(CK-19)免疫组化检测在肝细胞肝癌诊断和鉴别诊断中的价值

张世杰, 郎振为, 王欣欣, 吕福东

首都医科大学附属北京佑安医院病理科,北京 100069

收稿日期:2010-11-30 修回日期:1900-01-01 出版日期:2011-10-21 发布日期:2011-10-21
通讯作者: 吕福东

Value of combined application of glypican-3 and cytokeratin-19 in diagnosis and differential diagnosis of hepatocellular carcinoma

ZHANG Shi-jie, LANG Zhen-wei, WANG Xin-xin, LV Fu-dong

Department of Pathology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China

Received:2010-11-30 Revised:1900-01-01 Online:2011-10-21 Published:2011-10-21

摘要/Abstract

摘要： 目的探讨磷脂酰肌醇蛋白多糖-3(glypican-3,GPC-3)及细胞角蛋白-19(cytokeratin-19,CK-19)免疫组化检测在诊断和鉴别诊断肝细胞肝癌(hepatocellular carcinoma,HCC)、肝内胆管癌(intrahepatic cholangiocarcinoma,ICC)及肝细胞癌合并肝内胆管细胞癌(combined hepatocellular and cholangiocarcinoma,CHC)中的价值,以及对HCC的预后进行判断应用。方法收集首都医科大学附属北京佑安医院病理科142例患者的肝癌组织标本,其中肝细胞肝癌94例、肝内胆管细胞癌32例、肝细胞癌合并肝内胆管细胞癌16例,采用GPC-3及CK-19免疫组化染色,比较GPC-3及CK-19在这3组病例的肝癌细胞及肝内胆管癌细胞的表达及分布。结果免疫组化检测GPC-3,HCC中检测出79例阳性(84%),其中在中低分化组中的阳性率和表达强度都明显高于高分化组,表达强度与HCC分化程度有相关性(P<0.001)。ICC组中阳性5例(15.6%),而CHC组中16例均为阳性(100%);CK-19免疫组化检测,HCC组中均为阴性,ICC组有31例阳性(96.6%),CHC组16例均为阳性。结论 GPC-3免疫组化检测对HCC和CHC诊断具有高度特异性、敏感性,联合采用GPC-3和CK-19对HCC、ICC、CHC的诊断和鉴别诊断有重要价值。

关键词: 肿瘤, 肝细胞癌, 肝内胆管癌, 免疫组化, GPC-3, CK19

Abstract: Objective To evaluate combined application of glypican-3 and cytokeratin-19 in diagnosis and differential diagnosis of hepatocellular carcinoma(HCC). Methods Totally 142 cases of HCC were chosen in our hospital from Dec. 2009 to Mar. 2011. Among these patients, 94 had HCC, 32 had intrahepatic cholangiocarcinoma(ICC), 16 had combined hepatocellular and cholangiocarcinoma(CHC). Adoptive HE, glypican-(GPC-3) and cytokeratin-19(CK-19) immunohistochemical-staining was performed, and the results of GPC-3 were compared with those of CK-19 in the three groups in expression and distribution in HCC, ICC, and CHC. Results Positive result of GPC-3 was found in 79 cases(84%) with HCC, 5 cases(15.6%) with ICC, and 16 cases(100%) with CHC. Immunostaining for CK-19 was negative in all HCC cases, while it was positive in 31cases(97%) with ICC, and in 16 cases(100%) with CHC. Staining intensity and positive rate of GPC-3 in the moderately/poorly differentiated groups of HCC cases was higher than that in the well differentiated group. Staining intensity was related to the extent of differentiation(P<0.001). Conclusion Expression of GPC-3 had high degree of specificity and sensibility in HCC and CHC cases. Combined application of GPC-3 and CK-19 may have important diagnostic value in distinguishing HCC from ICC and CHC.

Key words: oncoma, hepatocellular carcinoma, intrahepatic cholangiocarcinoma, immunohistochemistry, glypican-3, cytokeratin-19

中图分类号:

R 36

张世杰;郎振为;王欣欣;吕福东. 联合应用磷脂酰肌醇蛋白多糖-3(GPC-3)和细胞角蛋白-19(CK-19)免疫组化检测在肝细胞肝癌诊断和鉴别诊断中的价值[J]. 首都医科大学学报, 2011, 32(5): 653-657.

ZHANG Shi-jie;LANG Zhen-wei;WANG Xin-xin;LV Fu-dong. Value of combined application of glypican-3 and cytokeratin-19 in diagnosis and differential diagnosis of hepatocellular carcinoma[J]. Journal of Capital Medical University, 2011, 32(5): 653-657.

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联合应用磷脂酰肌醇蛋白多糖-3(GPC-3)和细胞角蛋白-19(CK-19)免疫组化检测在肝细胞肝癌诊断和鉴别诊断中的价值

Value of combined application of glypican-3 and cytokeratin-19 in diagnosis and differential diagnosis of hepatocellular carcinoma

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