磷脂酰肌醇蛋白聚糖 3 在原发性肝癌组织中的表达及意义

 目的 探讨磷脂酰肌醇蛋白聚糖 3（GPC3）与原发性肝癌发生发展的关系，以及能否作为一个新的肝癌预警分子。方法 肝癌及癌旁组织取自 160 例术前未经放疗、化疗的原发性肝癌患者的手术切除标本，应用免疫组织化学 SP 法检测 GPC3 在癌及癌旁组织中的表达，分析 GPC3 表达与患者性别（男性 89 例，女性 71 例）、年龄（≤ 50 岁 102 例，> 50 岁 58 例）、血清 HBsAg（阳性 102 例， 阴性 58 例）、甲胎蛋白（< 300 μg/L 61 例，≥ 300 μg/L 99 例）、肿瘤大小（直径 ≤ 5 cm 104 例，> 5 cm 56 例）、肿瘤分化程度（高分化 48 例，中分化 55 例，低分化 57 例）的关系。结果 GPC3 表达阳性率肝癌组织为 74.4%（119/160），癌旁组织为 43.8%（70/160），肝癌组织明显高于癌旁组织 （χ²= 17.21，P < 0.05）。GPC3 表达与血清 HBsAg、肿瘤大小及分化程度有明显相关性。GPC3 表达阳性率血清 HBsAg 阳性者为 79.4%（81/102），阴性者为 65.5%（38/58，P < 0.05）；肿瘤直径 ≤ 5 cm 者为 69.2%（72/104），> 5 cm 者为 83.9%（47/56，P < 0.05）；肿瘤组织高分化者为 60.4%（29/48），中分化者为 80.0%（44/55），低分化者为 80.7%（46/57），高分化组织明显低于中低分化组织（P< 0.05）。结论 GPC3 可能在原发性肝癌发生、发展中起重要作用，并有可能成为肝癌的预警分子。

The expression of Glypican-3 in Hepatocellular carcinoma and its significance

Objective To study the relationship between glypican-3 (GPC3) and hepatocellular carcinoma, and to the clinical value of GPC3 as a prognostic factor. Methods A total of 160 patients with primary hepatocellular carcinoma, who received surgical treatment without preoperative chemotherapy or radiotherapy, were enrolled in this study. Among the patients, 89 were men and 71 were women; 102 of them were younger than or equal to 50 years, and 58 were older than 50; the serum HBsAg was positive in 102 patients, and negative in 58; the serum level of AFP < 300 μg/L in 61 of the patients, and ≥ 300 μg/L in 99; the tumor was ≤ 5 cm in diameter in 104 cases, and > 5 cm in 56; the tumor was highly differentiated in 48 of the patients, moderately differentiated in 55, and poorly differentiated in 57. Hepatocellular carcinoma specimen and adjacent tissues were obtained from the patients after the surgery. SP immunohistochemical staining was used to study the expression of GPC3 in the tissue samples. The relationship between the expression of GPC3 and the sex, age, HBsAg, serum level of APF, and size and differentiation of the tumor were evaluated. Results The expression of GPC3 was detected in 74.4% (119/160) of the hepatocellular carcinoma tissue samples, and 43.8% (70/160) of the adjacent sclerosis tissues (χ² = 17.21, P < 0.05). The expression was significantly related to the HBsAg seropositivity, and the size and differentiation of the tumor. The expression of GPC3 was detected in 79.4% (81/102) of the patients with positive serum HBsAg and 65.5% (38/58) of the patients with negative serum HBsAg (P< 0.05). In the patients with the tumor ≤ 5 cm or > 5 cm in diameter, the positive rate of GPC3 was 69.2% (72/104) and 83.9% (47/56), respectively (P < 0.05). The positive rate of GPC3 expression in highly differentiated tumor tissues was significantly lower than those in moderately and poorly differentiated tumors 60.4% (29/48) vs. 80.0% (44/55) and 80.7% (46/57) respectively, P < 0.05]. Conclusions GPC3 may play a significant role in the pathogenesis of primary hepatocellular tumors. It can be used as a prognostic factor for the tumor.