肝脏肿瘤组织中HEP、AFP、CK19及CD1O的表达及意义

目的研究HEP、AFP、CK19及CD10在肝脏肿瘤组织中的表达及在鉴别诊断中的应用价值。方法对272例肝细胞肝癌（HCC）、62例胆管细胞癌（BCC）、27例混合性肝癌（CHC）、40例肝脏转移性癌（MC）及10例肝血管平滑肌脂肪瘤（AML）分别进行HEP、AFP、CK19及CD10免疫组织化学标记。结果HEP在HCC中表达率为91．91％，明显高于BCC（9．67％）、MC（12．5％）及AML（0％）（P〈0．01），且HEP表达与HCC的分化相关；AFP在HCC、BCC、CHC、MC及AML中表达率分别为47．79％（130／272），0％（0／62）、48．14％（13／27），10％（4／40），0％（0／10），其在HCC中的表达亦明显高于BCC、MC及AML（P〈0．01）；HCC及BCC中CK19的表达率分别为23．16％（63／272）、100％（62／62），后者明显高于前者（P〈0．01）；而CDl0在HCC中呈现特征性的细胞间小粱状、分支状及逗点状着色，阳性率为50．74％，而在BCC、MC及AML均无此着色。结论联合检测HEP、AFP、CK19及CD10对区别HCC及非HCC具有较高的应用价值。

The Expression and Clinicopathologic Significance of HEP,AFP,CK19 and CD10 in Hepatic Tumors

Objective To study the expression of HEP,AFP,CK19 and CD10 in hepatic tumors and to explore the utility in differential diagnosis of hepatic tumors.Methods 272 cases with HCC,62 cases with BCC,27 cases with CHC,40 cases with MC and 10 cases with AML were immunohistochemically detected with HEP,AFP,CK19 and CD10.Results The positive expression rate of HEP was 91.91% in HCC,and it was higher than that in BCC(9.67%),MC(12.5%)and AML(0%),P<0.01,and the expression was associated with the differentiation of the HCC;In the five types tumors,the expression rates of AFP were 47.79%(130/272),0%(0/62),48.14%(13/27),10%(4/40),0%(0/10) respectively,and the rates in HCC were higher than those in the BCC,MC and AML;The expression rate of CK19 in BCC was 100%(62/62),while in HCC was 23.16%(63/272),the former was higher than the later(P<0.01);the stain style of CD10 in HCC was characteristically canalicular,branching or dot-like,and the rate was 50.74%,while no cases in BCC,MC and AML.Conclusions The combined usage of HEP,AFP,CK19 and CD10 is valuable in the differential diagnosis of hepatic tumors.