HBV相关肝硬化结节癌变的MR增强特征与GPC-3、CD34表达的对应性研究

doi:10.3969/j.issn.1006-7795.2016.05.022

首都医科大学学报 ›› 2016, Vol. 37 ›› Issue (5): 672-679.doi: 10.3969/j.issn.1006-7795.2016.05.022

HBV相关肝硬化结节癌变的MR增强特征与GPC-3、CD34表达的对应性研究

张琦, 李宏军, 李云芳, 张岩岩, 袁星星, 常静

首都医科大学附属北京佑安医院放射科, 北京 100069

收稿日期:2016-06-10 出版日期:2016-10-21 发布日期:2016-10-19
通讯作者: 李宏军 E-mail:lihongjun00113@126.com
基金资助:
北京市医院管理局重点医学专业发展计划（ZYLX201511）。

MR enhancement features of multistep hepatocarcinogenesis in HBV-related cirrhotic livers: correlation with GPC-3 and CD34

Zhang Qi, Li Hongjun, Li Yunfang, Zhang Yanyan, Yuan Xingxing, Chang Jing

Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China

Received:2016-06-10 Online:2016-10-21 Published:2016-10-19
Supported by:
This study was supported by Beijing Municipal Administration of Hostpitals Clinical Development of Special Funding (ZYLX201511).

摘要/Abstract

摘要： 目的探索乙型肝炎病毒（hepatitis B virus，HBV）相关肝硬化结节癌变磁共振（magnetic resonance，MR）动态增强特征与免疫组织化学标志物磷脂酰肌醇蛋白聚糖-3（glypican-3，GPC-3）及CD34表达量之间的对应关系。方法收集44个乙型肝炎（以下简称乙肝）肝硬化患者中经病理证实的47个肝硬化结节纳入本研究，术前均行MR扫描，用软件将动态增强扫描序列自动生成时间-信号曲线，术后常规病理及免疫组织化学染色，观察GPC-3和CD34表达。结果 1）在47个结节中，GPC-3在早期肝癌（early hepatocellular carcinoma，eHCC），高级不典型增生结节（high grade dysplastic nodule，HGDN），低级不典型增生结节（low grade dysplastic nodule，LGDN）各组中的阳性率分别为78.9%、26.1%、0%，CD34强阳性表达在eHCC、HGDN及LGDN中分别为78.9%、56.5%、0%，差异均有统计学意义（P<0.05）。2）eHCC、HGDN、LGDN的MR动态灌注时间-信号曲线特点分别倾向为陡升型、缓升型、平行型。GPC-3阳性的结节和阴性的结节两者之间时间信号曲线差异有统计学意义（P<0.05）。CD34强阳性、弱阳性、阴性的eHCC之间时间-信号曲线差异有统计学意义（P<0.05）。结论 1）MR时间-信号曲线特点对eHCC及HGDN的鉴别诊断有一定的价值。2）GPC-3表达阳性具有提示结节良恶性的诊断价值，同时MR时间-信号曲线表现为陡升型。3）CD34表达量与MR增强时间-信号曲线呈正相关。

关键词: 肝硬化, 不典型增生结节, 早期肝癌, 磁共振成像, GPC-3, CD34

Abstract: Objective To study the correlation between MR(magnetic resonance) enhancement features and GPC-3 (glypican-3) and CD34 expression in hepatic B Virus (HBV)-related liver cirrhosis nodules. Methods This retrospective study collected 47 pathology proven nodules in 44 HBV-related liver cirrhosis patients, who underwent MRI and made the time-signal curve of dynamic enhancement, and we also evaluated the immunohistochemical biomarkers levels of GPC-3 and CD34. Results 1) In the 47 nodules, GPC-3 positive rate in early hepatocellular carcinoma (eHCC), high grade dysplastic nodule (HGDN), low grade dysplastic nodule(LGDN) were 78.9%, 26.1% and 0%, respectively (P=0.000), CD34 positive rates were respectively 78.9%, 56.5%, 0%, and the difference was statistically significant (P=0.005). 2) The MR time-signal features at different stage of nodules, GPC-3 positive and negative nodules, CD34 strongly positive and weakly positive and negative nodules, were statistically significant(P<0.05). Conclusion 1) MR time-signal curve has a certain differential diagnostic value for early stage of HCC. 2) GPC-3 is a highly specific biomarker for the malignance, while MR time-signal curve inclined to show rapid rise type. 3) CD34 expression was positively correlated with MR time-signal curve.

Key words: liver cirrhosis, dysplastic nodules, early hepatocellular carcinoma, magnetic resonance imaging, GPC-3, CD34

中图分类号:

张琦, 李宏军, 李云芳, 张岩岩, 袁星星, 常静. HBV相关肝硬化结节癌变的MR增强特征与GPC-3、CD34表达的对应性研究[J]. 首都医科大学学报, 2016, 37(5): 672-679.

Zhang Qi, Li Hongjun, Li Yunfang, Zhang Yanyan, Yuan Xingxing, Chang Jing. MR enhancement features of multistep hepatocarcinogenesis in HBV-related cirrhotic livers: correlation with GPC-3 and CD34[J]. Journal of Capital Medical University, 2016, 37(5): 672-679.

参考文献

[1] Liu J,Fan D.Hepatitis B in china[J].Lancet,2007,369(9573):1582-1583.
[2] 李淑群, 陈谦. GP73与肝脏疾病关系的研究进展[J]. 世界华人消化杂志, 2010, 18(20):2117-2120.
[3] Yao M, Yao D F, Bian Y Z, et al. Oncofetal antigen glypican-3 as a promising early diagnostic marker for hepatocellular carcinoma[J]. Hepatobiliary Pancreat Dis Int, 2011, 10(3):289-294.
[4] Huh J, Kim K W, Kim J, et al. Pathology-MRI Correlation of Hepatocarcinogenesis:Recent Update[J]. J Pathol Transl Med, 2015, 49(3):218-229.
[5] Nakamura K,Zen Y,Sato Y,et al. Vascular endothelial growth factor,its receptor FLK-1,and hypoxia inducible factor-lalpha are involved in malignant transformation in dysplastic nodules of the liver[J].Hum Pathol,2007,38(10):1532-1546.
[6] Coston W M,Loera S,Lan S K,et al.Distinction of hepatocellular carcinoma from benign hepatic mimickers using Glypican 3 and CD34 immunohistochemistry[J].Am J Surg Pathol,2008,32(3):433-444.
[7] Enan E T, El-Hawary A K, EI-Tantawy D A, et al. Diagnostic role of glypican 3 and CD34 for differentiating hepatocellular carcinoma from nonmalignant hepatocellular lesions[J]. Ann Diagn Pathol,2013,17(6):490-493.
[8] Saad R S, Luckasevic T M, Noga C M, et al. Diagnostic value of HepPar1, pCEA, CD10,and CD34 expression in separating hepatocellular carcinoma from metastatic carcinoma in fine-needle aspiration cytology[J]. Diagn Cytopathol, 2004,30(1):1-6.
[9] Gong L, Wei L X, Ren P, et al.Dysplastic nodules with Glypican-3 immunostaining:A risk for early hepatocelluar carcinoma[J].PLOS One, 2014,9(1):e87120.
[10] Libbrecht L, Severi T, Cassiman D, et al. Glypican-3 expression distinguishes small hepatocellular carcinomas from cirrhosis, dysplastic nodules, and focal nodular hyperplasia-like nodules[J]. Am J Surg Pathol, 2006, 30(11):1405-1411.
[11] Wang X Y, Degos F, Dubois S, et al. Glypican-3 expression in hepatocellular tumors:diagnostic value for preneoplastic lesions and hepatocellular carcinomas[J]. Human pathol, 2006, 37(11):1435-1441.
[12] Wang H L, Anatelli F, Zhai Q J, et al. Glypican-3 as a useful diagnostic marker that distinguishes hepatocellular carcinoma from benign hepatocellular mass lesions[J]. Arch Pathol Lab Med,2008, 132(11):1723-1728.
[13] Yamauchi N, Watanabe A, Hishinuma M, et al. The glypican 3 oncofetal protein is a promising diagnostic marker for hepatocellular carcinoma[J]. Mod Pathol,2005,18(12):1591-1598.
[14] 杜经丽, 韦立新, 王玉兰. 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[J]. 中华病理学杂志, 2011, 40(1):11-16.
[15] Yao S, Zhang J, Chen H, et al. Diagnostic value of immunohistochemical staining of GP73, GPC3, DCP, CD34, CD31, and reticulin staining in hepatocellular carcinoma[J]. J Histochem Cytochem, 2013,61(9):639-648.
[16] 畅俊平, 王丽霞. GPC3和CD34在肝细胞性肝癌中的表达及临床意义[J]. 中国药物与临床, 2013, 13(z1):4-5.
[17] Kim H D, Lim Y S, Han S, et al. Evaluation of early-stage hepatocellular carcinoma by magnetic resonance imaging with gadoxetic acid detects additional lesions and increases overall survival[J]. Gastroenterology, 2015, 148(7):1371-1382.

HBV相关肝硬化结节癌变的MR增强特征与GPC-3、CD34表达的对应性研究

MR enhancement features of multistep hepatocarcinogenesis in HBV-related cirrhotic livers: correlation with GPC-3 and CD34

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	冯颖, 时克, 王宪波. 肝硬化合并肠系膜上静脉栓塞患者2年预后预测模型的构建与验证[J]. 首都医科大学学报, 2023, 44(1): 107-114.
[2]	程芮, 朱思莹, 刘思茂, 周艳华, 宗晔, 李鹏, 张澍田. 内镜下治疗食管胃底静脉曲张伴发上消化道肿物的经验[J]. 首都医科大学学报, 2022, 43(1): 22-27.
[3]	张慧博, 杨晓旭, 刘欣圆, 顾华, 王双坤, 杨旗. 磁共振影像对脑静脉窦血栓形成的诊断价值研究[J]. 首都医科大学学报, 2022, 43(1): 67-73.
[4]	张越, 卢洁. 颈动脉粥样硬化斑块稳定性评估正电子发射断层扫描/磁共振研究进展[J]. 首都医科大学学报, 2021, 42(1): 31-36.
[5]	郑爽爽, 高志远, 宋双双, 何悦明, 卢洁. BOLD MRI评价糖尿病患者尿微量白蛋白及氧合水平的研究[J]. 首都医科大学学报, 2021, 42(1): 125-130.
[6]	杨阳, 康骅, 赵菁, 凌煜玮, 赵烨, 王亚军, 戎冬冬. 术前乳腺MRI对乳腺癌保乳手术切缘评估的回顾性分析[J]. 首都医科大学学报, 2020, 41(6): 943-953.
[7]	白志杰, 王新胜, 马洪顺, 李波. mpMRI与超声融合导航技术在前列腺靶向穿刺的临床研究[J]. 首都医科大学学报, 2020, 41(4): 631-635.
[8]	张闻平, 吴静, 任彦军, 常莹, 张雪娟, 马佳, 杜岚, 杨敬春. 直肠腔内超声与磁共振诊断直肠肿瘤的比较研究[J]. 首都医科大学学报, 2020, 41(4): 641-646.
[9]	王佳, 乐凯, 郭懿樊, 郭旭, 张涛, 任宇, 王睿斌, 许光中, 郑海亮, 冯树理, 朱斌. 同步辐射X线相衬成像对裸鼠胰腺癌的早期诊断[J]. 首都医科大学学报, 2019, 40(2): 195-200.
[10]	李敏, 蒋涛. 增强MRI对睾丸肿瘤及肿瘤样病变病理分型的诊断价值[J]. 首都医科大学学报, 2019, 40(2): 305-311.
[11]	丁乔, 岳云, 程灏. 特利加压素对肝硬化门脉高压患者围术期肾保护作用的探讨[J]. 首都医科大学学报, 2018, 39(5): 741-746.
[12]	王丽, 蒋涛, 姜桦, 高文. 3.0T MRI多b值扩散加权平面回波成像对多发性骨髓瘤的诊断价值[J]. 首都医科大学学报, 2018, 39(3): 320-326.
[13]	隋滨滨, 高培毅, 林燕, 赵海清, 宋立刚. 应用磁共振4D flow成像对正常颅内前循环动脉血流动力学参数定量评估的可重复性研究[J]. 首都医科大学学报, 2018, 39(2): 157-162.
[14]	樊响, 杨延辉, 贾秀琴, 卢洁, 李坤成. 轻度认知障碍静息态功能磁共振研究低频振幅分析[J]. 首都医科大学学报, 2018, 39(2): 163-166.
[15]	张苗, 汪胜佩, 胡迪, 康惠颖, 何晖光, 彭芸. 基于图论的戈谢病患儿静息态功能脑网络分析[J]. 首都医科大学学报, 2018, 39(2): 167-172.