GPC3、HSP70和GS在高分化肝细胞癌中的诊断意义

目的探讨磷脂酰肌醇蛋白聚糖3(GPC3)、热休克蛋白70(HSP70)和谷氨酰胺合成酶(GS)在高分化肝细胞癌、肝局灶性结节状增生、肝硬化和正常肝组织中的表达及其鉴别诊断意义。方法应用免疫组织化学方法(EnVision法)对30例高分化肝细胞癌及其癌旁肝硬化组织、15例肝局灶性结节状增生及其病灶旁肝组织分别行GPC3、HSP70和GS抗体标记,分析这些抗体在高分化肝细胞癌、肝局灶性结节状增生、肝硬化和正常肝组织中的表达情况。结果 GPC3和HSP70在高分化肝细胞癌中的表达阳性率分别为80.0%、83.3%,但在肝局灶性结节状增生、癌旁肝硬化组织和正常肝组织均阴性表达,高分化肝细胞癌GPC3和HSP70的表达阳性率与肝局灶性结节状增生、肝硬化和正常肝组织差异均有统计学意义(P<0.01)。GS在肝硬化和正常肝组织中主要是中央静脉周围和硬化结节周围肝细胞染色、呈条带状染色分布,在w-HCC中主要呈弥漫阳性表达或完全阴性,在FNH主要呈较大范围的"地图样"表达。GS染色在高分化肝细胞癌中的分布范围与肝局灶性结节状增生差异无统计学意义(P>0.05),但与肝硬化结节和正常肝组织差异均有统计学意义(P<0.01)。结论 GPC3、HSP70和GS有助于高分化肝细胞癌与肝局灶性结节状增生及肝硬化的鉴别诊断,但GS染色在高分化肝细胞癌和肝局灶性结节状增生中的分布有一定交叉性,因此在诊断高分化肝细胞癌时应审慎判读GS染色结果。

Diagnostic significance of GPC3, HSP70 and GS in well-differentiated hepatocellular carcinoma

Objective To investigate the expression of glypican-3（GPC3）, heat shock protein 70（HSP70）and glutamine synthetase（GS）in well-differentiated hepatocellular carcinoma（w-HCC）,focal nodular hyperplasia（FNH）, liver cirrhosis, normal liver tissues and their differential diagnostic significance. Methods Three immunohistochemical markers-GPC3,GS and HSP70 were detected (EnVision) and analyzed in 30 cases of w-HCC and its adjacent cirrhosis tissues ,15 cases of FNH and its adjacent normal liver tissues. Results The positive rates of GPC3 and HSP70 in w-HCC were 80.0％ and 83.3％,respectively,but they were negative in FNH, liver cirrhosis and normal liver tissues. The positive rates of GPC3 and HSP70 in w-HCC were significantly different from those in FNH, liver cirrhosis and normal liver tissues（P<0.01）. GS was mainly expressed in hepatocytes around the central vein and cirrhosis nodules in liver cirrhosis and normal liver tissues, showing banded staining distribution.The expression of GS in w-HCC was diffusely positive or completely negative, while that in FNH was mostly "map-like" expression. The distribution of GS staining in w-HCC was not significantly different from that in FNH（P>0.05）, but significantly different from that in liver cirrhosis and normal liver tissues （P<0.01）. Conclusion GPC3, HSP70 and GS are helpful in differentiating w-HCC from FNH and liver cirrhosis. However, the distribution of GS in w-HCC and FNH is overlapped. Therefore, the results of GS staining should be carefully interpreted in the diagnosis of w-HCC.