原发性肝癌不同病理组织类型中肝干细胞的分析***

背景：近年来,有观点认为原发性肝癌的发生机制可能为肝干细胞分化不全或分化异常所致。目前,肝干细胞研究正处于起步阶段,对人原发性肝癌的“干细胞起源”学说尚需进一步验证。 目的：观察原发性肝癌不同病理组织类型中肝干细胞的活化、分布、来源和免疫表达特征。 设计：观察对比实验。 单位：解放军第三军医大学大坪医院野战外科研究所肿瘤中心。 对象： 实验于2003-09/2004-07在解放军第三军医大学大坪医院野战外科研究所肿瘤中心完成,选用94例肝细胞癌和12例肝内胆管细胞癌和10例混合型肝癌石蜡包埋组织,同时选用5例肝硬化和4例正常肝组织作为实验对照,均取自病理科存档资料。肝癌组织均为患者首次肝癌切除手术时采取,包括肿瘤组织和癌旁组织,患者均无化疗和放射治疗史,并对受检项目知情同意。实验主要抗体均购自Santa Cruz公司。 方法： 采用苏木精-伊红染色、免疫组织化学SP方法（检测的免疫标志有鼠抗人细胞角蛋白19单克隆抗体、鼠抗人细胞角蛋白7单克隆抗体、鼠抗人细胞角蛋白8&18单克隆抗体、鼠抗人c-kit单克隆抗体、鼠抗人Thy-1单克隆抗体、鼠抗人甲胎蛋白单克隆抗体）观察各病变类型肝干细胞免疫标志表达情况。 主要观察指标：各病变类型肝干细胞免疫标志表达情况。 结果：在原发性肝癌不同病理组织类型中干细胞免疫标志均有不同程度的表达,均可观察到肝干细胞向肝癌细胞的转化,以混合型肝细胞癌中肝干细胞免疫表型表达率最高(P < 0.05)。正常组和肝硬化组干细胞免疫表型特征为阴性。　 结论：不同病理组织类型的肝癌组织中均存在不同分化状态和不同来源的肝干细胞。

Quantitative monitoring after double unit umbilical cord blood transplantation in an adult*

BACKGROUND: Recently, some people believed that the mechanisms of primary hepatic carcinoma might be caused by poor differentiation or disdifferentiation of hepatic stem cells. Studies on hepatic stem cells are in the early stage at present, and the theory of "stem cell origins" of human primary hepatic carcinoma deserves further verification. OBJECTIVE: To investigate the activation, distribution, origin and immunological expression characteristics of hepatic stem cells in different histopathologic types of primary hepatic carcinoma. DESIGN: Observational comparative study. SETTING: Experiments were performed at the Laboratory of Tumor Center, Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA from September 2003 to July 2004. We took 94 cases of hepatic cellular cancer, 12 cases of intrahepatic cholangiocellular carcinoma and 10 cases of mixed hepatocarcinoma paraffin-embedded tissue blocks as research objects, with 5 cases of liver cirrhosis and 4 cases of normal liver as experimental control. These materials were collected from the archive of the Department of Pathology of Daping Hospital. Primary hepatic carcinoma tissues and corresponding adjacent liver tissues were obtained from patients who had undergone surgery for the removal of their tumors. All the patients were not treated by chemotherapy or radiotherapy before the operation. They had signed the informed consent. Main Antibodies were bought from Santa Cruz Company. PARTICIPANT: The histological and immunohistochemical characteristics were examined by haematoxylin and eosin staining and immunohistochemistry (SP method), including mouse antihuman cytokeratin 19 monoclonal antibody, mouse antihuman cytokeratin 7 monoclonal antibody, mouse antihuman cytokeratin 8&&18 monoclonal antibody, mouse antihuman c-kit monoclonal antibody, mouse antihuman Thy-1 monoclonal antibody, mouse antihuman alpha fetoprotein monoclonal antibody. METHODS: Expression of immunological markers of hepatic stem cells in different histopathologic types. RESULTS: Immunological markers of hepatic stem cells expressed variously in different histopathologic types of primary hepatic carcinoma. Hepatic stem cells differentiated into hepatoma carcinoma cells in all the types. The highest expression rate of hepatic stem cell immunophenotype was found in the mixed hepatocarcinoma (P < 0.05). Immunophenotypes of hepatic stem cells were negative in normal group and cirrhosis group. CONCLUSION: Hepatic stem cells of varied differentiations and origins existed in different histopathologic types of primary hepatic carcinoma.