Foschini M P, Macchia S, Baccarini P, Milandri G L, Losi L, Spongano P, Panarelli M, Dal Monte P R, Eusebi V
Dipartimento di Oncologia, Ospedale Bellaria, Università di Bologna.
Pathologica. 1999 Aug;91(4):260-7.
Extrahepatic neoplasms metastatic to the liver histologically are often indistinguishable from hepatocellular carcinoma (HCC). The differential diagnosis between HCC and metastatic liver tumours can be even more difficult in ultrasound guided fine-needle biopsies. Purpose of the present study was to investigate the utility of immunohistochemical staining with polyclonal anticarcinoembryonic antigen (pCEA) antibody and of in situ hybridization (ISH) revealing human albumin mRNA, with emphasis on tissues obtained via fine-needle procedure. Cases consisted of 52 primary HCC; 2 HCC metastatic to vertebral bones; 18 tumours metastatic to the liver; 24 non-hepatocellular tumours metastatic to the skin, lymph nodes and brain; 2 immature teratomas with areas of hepatoid differentiation. Forty-seven HCC (90%) and 7 liver metastases (38%) were obtained by ultrasound guided fine-needle biopsies (21 g needle was used). All the remaining cases were surgical specimens. All the cases were studied with immunohistochemistry for pCEA and ISH using a cRNA probe for human albumin mRNA. The immunohistochemical staining using pCEA showed a canalicular type of positivity in 37 cases of HCC (71%), in one HCC metastatic to vertebral bone and in the hepatoid areas of one immature teratoma. No canalicular type of positivity was obtained in non-hepatocellular neoplasms metastatic to the skin, brain, lymph-nodes and liver. Albumin mRNA was detected in 51 (98%) primary HCC, in both HCC bone metastases, and in the hepatoid areas of both immature teratomas. No positivity was obtained in non-hepatocellular tumours. The data here obtained indicate that immunostaining with pCEA and ISH revealing human albumin mRNA are markers of hepatocellular differentiation and confirm their diagnostic utility. Detection of albumin mRNA showed a higher sensitivity. In addition the cRNA probe here used seems more sensitive that the oligonucleotide probes employed in previous studies.
组织学上转移至肝脏的肝外肿瘤通常与肝细胞癌(HCC)难以区分。在超声引导下细针穿刺活检中,HCC与肝转移瘤之间的鉴别诊断可能更加困难。本研究的目的是探讨用多克隆抗癌胚抗原(pCEA)抗体进行免疫组化染色以及原位杂交(ISH)检测人白蛋白mRNA的实用性,重点是通过细针穿刺获得的组织。病例包括52例原发性HCC;2例转移至椎骨的HCC;18例转移至肝脏的肿瘤;24例转移至皮肤、淋巴结和脑的非肝细胞肿瘤;2例具有肝样分化区域的未成熟畸胎瘤。47例HCC(90%)和7例肝转移瘤(38%)通过超声引导下细针穿刺活检获得(使用21G针)。其余所有病例均为手术标本。所有病例均采用免疫组化检测pCEA,并使用人白蛋白mRNA的cRNA探针进行ISH检测。使用pCEA的免疫组化染色在37例HCC(71%)、1例转移至椎骨的HCC以及1例未成熟畸胎瘤的肝样区域显示出小管型阳性。转移至皮肤、脑、淋巴结和肝脏的非肝细胞肿瘤未获得小管型阳性。在51例(98%)原发性HCC、2例HCC骨转移瘤以及2例未成熟畸胎瘤的肝样区域均检测到白蛋白mRNA。非肝细胞肿瘤未获得阳性结果。此处获得的数据表明,pCEA免疫染色和ISH检测人白蛋白mRNA是肝细胞分化的标志物,并证实了它们的诊断实用性。白蛋白mRNA的检测显示出更高的敏感性。此外,此处使用的cRNA探针似乎比先前研究中使用的寡核苷酸探针更敏感。