CEA、CK_(8,18)、AFP和AAT在肝细胞癌中表达及意义

用免疫组化方法观察癌胚抗原(CEA)、低分子量细胞角蛋白((CK_(8,18))、甲胎蛋白(AFP)和a_l抗胰蛋白酶(AAT)在75例肝细胞癌(HCC)中的表达。其中,CEA57/75例阳性(76％);CK_(a,18)54/75例阳性(72％);AFP51/75例阳性(68％);AAT58/75例阳性(77.3％)。AFP和AAT在中等分化(Ⅱ级HCC中阳性率最高;CK_(8,18)在低分化(Ⅲ级)HCC中的表达比其他3种相对较高。CEA抗血清能显示HCC的毛细胆管分化,它是HCC的特征性标记,在病理鉴别诊断上有很大意义。CK_(,18)、AFP和AAT可见于非肝细胞来源的肿瘤,病理上的应用价值有限。AAT在HCC和癌周肝组织的阳性率分别为77.3％和66.7％,远比AFP68％和26.7％高,两者有显著差异(P<0.01)。因此,血清AAT的检测对HCC的诊断和预后估计可能比AFP更有意义。

EXPRESSION OF CEA, CK8,18, AFP AND AAT IN HEPATOCELLULAR CARCINOMA AND IT'S SIGNIFICANCE

Expression of CEA, CK8, 18, AFP and AAT in 75 cases of hepatocellular carcinoma (HCC) were studied with immunohistochemical methods. 57 of 75 cases (76%) were positive for CEA; 54 cases (72%) for CK8,18; 51 cases (68%) for AFP, 58 peases (77.3%) for AAT. The positive rate of AFP and AAT in moderately differentiated ( I grade) HCC was the highest in comparison with well or poorly differentiated HCC. The positive rate of CK8,18 in poorly differentiated HCC was relatively higher than in others. CEA antiserum can exhibit differentiation of bile canaliculi of HCC. The staining pattern of bile canaliculi of CEA antiserum is a characteristic marker for HCC. It is of significance in differential diagnosis pathologically. CK8.18, AFP and AAT may occur in the tumors of non-hepatocellular origin. The value of application is limited. AAT in HCC and peri-cancerous hepatic tissue was respectively 77.3% and 66.7%; much higher than AFP, 68% and 26.7%. The difference was statistically significant. It is suggested that the examination of AAT in serum may be of more significance than AFP in diagnosis and evaluation of prognosis for HCC.