肝癌衍生生长因子和细胞外基质蛋白-1对原发性肝内胆管细胞癌的鉴别诊断和预后意义

目的:研究肝癌衍生生长因子（HDGF）和细胞外基质蛋白-1（ECM1）对原发性肝内胆管细胞癌（PICC）和结直肠癌（CRC）的鉴别诊断价值。方法:对55例PICC、60例肝脏转移性CRC以及60例原发性CRC标本行免疫组织化学（IHC）染色和统计学处理。结果:32例(58.2%)PICC归为肿块型，13例(23.6%)为导管内乳头状型，10例(18.2%)为周围导管浸润型。PICC中ECM1表达与男性(P=0.033)、肝门区(P=0.027)、导管内乳头黏液腺瘤(P=0.000)和肠型上皮细胞(P<0.001)显著相关。HDGF+/ECM1-免疫表型诊断PICC有100%的阳性预测值（PPV）。HDGF-/ECM1+免疫表型诊断转移性CRC有84.2%的PPV值。HDGF+/ECM1+免疫表型诊断PICC和转移性CRC分别有86.7%和13.3%的PPV值。单变量Cox生存分析55例PICC标本，确认浸润深度(P=0.005)、淋巴结转移(P=0.012)、肿瘤阶段(P=0.004)以及血管浸润(P=0.023)与病人不良预后显著相关。多变量Cox生存分析认为:肿瘤阶段(P=0.002)与病人生存期差有关。结论:PICC中的ECM1表达与性别、肿瘤位置、导管内乳头状生长型及肠表型呈统计学相关。HDGF和ECM1联合可作为鉴别PICC和转移性CRC的有用指标。

Differential diagnosis and prognosis value of hepatoma -derived growth factor and extra-cellular matrix protein 1 to primary intrahepatic cholangiocarcinoma

Objective:To analyzd differential diagnosis of hepatoma -derived growth factor(HDGF)and extracel-lular matrix protein 1(ECM1)to primary intrahepatic cholangiocarcinoma(PICC)and colorectal carcinoma(CRC). Methods:A total of 55 cases of PICC operation specimens,60 cases of metastatic CRC and 60 cases of primary CRC were tested by immunohistochemistry(IHC)staining and statistical processing.Results:32 cases(58.2%)PICC were mass type,13 cases(23.6%)were intraductal papillary type,10 cases(18.2%)were periductal infiltrative type.ECM1 expression in PICC was significantly related with male(P =0.033),hilar location(P =0.027),intraduc-tal papillary(P =0.000)and intestinal epithelial type(P <0.001).HDGF +/ECM1 -immune phenotype had 100%positive predictive value(PPV)in diagnosing PICC.HDGF -/ECM1 + immune phenotype had 84.2% PPV in diagno-sing metastatic CRC.HDGF +/ECM1 + immune phenotype had 86.7% and 13.3% PPV in differential diagnosing PICC and metastaticrespectively.Single variable Cox survival analysised 5 5 PICC confirmed infiltration depth (P=0.005),lymph node metastasis(P =0.012),tumor stage(P =0.004)and vascular invasion(P =0.023)were sig-nificantly related with patients'bad prognosis.Through multivariate Cox survival analysis:tumor stage(P =0.002)be-ing associated with poor survival.Conclusion:ECM1 expression in PICC was related with gender,tumor location,in-traductal papillary growth type and intestinal phenotype.Combined HDGF with ECM1 can be used as useful index for differential diagnosis of PICC and metastatic CRC.