Saftoiu A, Ciurea T, Georgescu Claudia, Banita Monica, Comanescu Violeta, Rogoveanu I, Gorunescu F, Georgescu I
Department of Internal Medicine, University of Medicine and Pharmacy Craiova, Craiova, Romania.
J Cell Mol Med. 2003 Oct-Dec;7(4):436-46. doi: 10.1111/j.1582-4934.2003.tb00246.x.
A complementary way for the assessment of HCC prognosis is represented by the analysis of molecular markers. Thus, immunohistochemical assessment of proliferation can describe tumor aggressiveness, probability of local recurrence or metastasis potential, being very useful for the assessment of recurrence-free survival and survival until death. The aim of our study was to assess proliferating cell nuclear antigen activity in HCC and dysplastic nodules as compared with surrounding non-neoplasic areas. Immunohistochemical techniques were thus performed on the samples obtained by ultrasound-guided liver biopsies or intraoperative biopsies, in 32 patients with HCC, as well as in 3 patients with dysplastic nodules occurring in liver cirrhosis. Expression of PCNA within extranodular areas of the HCC patients in the absence or presence of cirrhosis, was increasing from 40% to 70%, respectively. PCNA expression further increased within intranodular areas of dysplastic nodules and HCC, to 100% and 96.88%, respectively. A progressive increase of the mean values of PCNA-LI was also observed from extranodular areas without or with cirrhosis, towards intranodular areas of dysplastic nodules and HCC (4.2%, 6.8%, 27.9%, 31.9%, respectively). Dysplastic nodules can thus be considered lesions with a high-proliferation rate, representing an early stage of hepatocarcinogenesis. This supported the current recommendations for borderline hepatocellular nodules identified by ultrasound, which indicate an aggressive treatment similar to malignant lesions. In summary, we demonstrated a progressively increasing rate of cellular proliferation, from extranodular non-neoplasic areas to intranodular areas (dysplastic nodules and HCC), as reflected by an increased expression of proliferating cell nuclear antigen labelling index.
评估肝癌预后的一种补充方法是分析分子标志物。因此，增殖的免疫组织化学评估可以描述肿瘤的侵袭性、局部复发的可能性或转移潜能，这对于评估无复发生存期和直至死亡的生存期非常有用。我们研究的目的是评估肝癌和发育异常结节中增殖细胞核抗原的活性，并与周围非肿瘤区域进行比较。我们对32例肝癌患者以及3例肝硬化中出现发育异常结节的患者，通过超声引导下肝活检或术中活检获取的样本进行了免疫组织化学技术检测。在有或无肝硬化的肝癌患者结节外区域，PCNA的表达分别从40%增加到70%。在发育异常结节和肝癌的结节内区域，PCNA表达进一步增加，分别达到100%和96.88%。从无肝硬化或有肝硬化的结节外区域到发育异常结节和肝癌的结节内区域，也观察到PCNA-LI平均值的逐渐增加（分别为4.2%、6.8%、27.9%、31.9%）。因此，发育异常结节可被视为具有高增殖率的病变，代表肝癌发生的早期阶段。这支持了目前对于超声检查发现的临界肝细胞结节的建议，即表明应采取与恶性病变相似的积极治疗。总之，我们证明了从结节外非肿瘤区域到结节内区域（发育异常结节和肝癌）细胞增殖率逐渐增加，这通过增殖细胞核抗原标记指数的表达增加得以体现。
