Kitagawa Y, Iwai M, Muramatsu A, Tanaka S, Mori T, Harada Y, Okanoue T, Kashima K
Third Department of Internal Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Histopathology. 2002 May;40(5):472-9. doi: 10.1046/j.1365-2559.2002.01374.x.
We investigated expression of CEA, CA19-9 and DU-PAN-2 in liver tissues of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma, measuring their serum value to clarify their clinical significance, and proliferating cell nuclear antigen (PCNA) was assessed in serial sections to determine whether expression of these molecules in chronic liver disease was related to regeneration of biliary ducts.
Liver tissues were biopsied under peritoneoscopy or echo-guidance and resected surgically among 63 patients with anti-hepatitis C virus-positive sera. There were 26 cases of chronic hepatitis, 21 cases of liver cirrhosis and 16 cases of hepatocellular carcinoma (four cases of mixed type). They were simultaneously used for immunocytochemistry for CEA, CA19-9 and DU-PAN-2, and PCNA was demonstrated in serial liver tissues by immunohistochemistry. Serum CEA, CA19-9 and DU-PAN-2 were measured by radioimmunoassay or enzyme immunoassay. In chronic hepatitis and liver cirrhosis CEA immunoreactivity was seen on membranes facing bile canaliculi and in bile ductules. Both CA19-9 and DU-PAN-2 immunoreactivity were observed in bile ductules in chronic hepatitis liver cirrhosis and non-neoplastic areas surrounding hepatocellular carcinoma, and CA19-9 was also present in interlobular bile ducts. PCNA immunoreactivity was not detected in marker-positive bile ductules or interlobular bile ducts. In hepatocellular carcinoma CEA immunoreactivity was seen on membrane facing dilated bile canaliculi in glandular structures, and CEA, CA19-9 and DU-PAN-2 immunoreactivity was observed in cholangiolar areas in mixed type of hepatocellular carcinoma.
CEA in chronic hepatitis and liver cirrhosis is expressed not only in bile ductules but also on membrane facing bile canaliculi, and both CA19-9 and DU-PAN-2 were seen in different levels of biliary ducts. These molecules were expressed in bile ductules in surrounding non-neoplastic areas of hepatocellular carcinoma, and their expression was not associated with regeneration of biliary ducts. CEA expression was present in the trabecular type of hepatocellular carcinoma, and CA19-9 and DU-PAN-2 were observed in cholangiolar areas in mixed type of hepatocellular carcinoma.
我们研究了癌胚抗原（CEA）、糖类抗原19-9（CA19-9）和DU-PAN-2在慢性肝炎、肝硬化及肝细胞癌肝组织中的表达情况，检测其血清值以阐明其临床意义，并在连续切片中评估增殖细胞核抗原（PCNA），以确定这些分子在慢性肝病中的表达是否与胆管再生有关。
对63例抗丙型肝炎病毒血清阳性患者，在腹腔镜或超声引导下进行肝组织活检，并手术切除肝组织。其中慢性肝炎26例，肝硬化21例，肝细胞癌16例（4例为混合型）。同时将这些组织用于CEA、CA19-9和DU-PAN-2的免疫细胞化学检测，并通过免疫组织化学在连续肝组织切片中检测PCNA。采用放射免疫分析或酶免疫分析检测血清CEA、CA19-9和DU-PAN-2。在慢性肝炎和肝硬化中，CEA免疫反应性见于面向胆小管的细胞膜及胆小管内。CA19-9和DU-PAN-2免疫反应性在慢性肝炎、肝硬化的胆小管及肝细胞癌周围的非肿瘤区域均可见，CA19-9也存在于小叶间胆管。在标记阳性的胆小管或小叶间胆管中未检测到PCNA免疫反应性。在肝细胞癌中，CEA免疫反应性见于腺管结构中面向扩张胆小管的细胞膜，在混合型肝细胞癌的胆小管区域可见CEA、CA19-9和DU-PAN-2免疫反应性。
慢性肝炎和肝硬化中的CEA不仅在胆小管中表达，也在面向胆小管的细胞膜上表达，CAI9-9和DU-PAN-2在不同水平的胆管中均可见。这些分子在肝细胞癌周围的非肿瘤区域的胆小管中表达，其表达与胆管再生无关。小梁型肝细胞癌中有CEA表达，混合型肝细胞癌的胆小管区域可见CA19-9和DU-PAN-2。
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