HSP70、磷脂酰肌醇蛋白聚糖3和谷氨酰胺合成酶在肝硬化肝细胞结节中的诊断价值
Diagnostic value of HSP70, glypican 3, and glutamine synthetase in hepatocellular nodules in cirrhosis.
作者信息
Di Tommaso Luca, Franchi Giada, Park Young Nyun, Fiamengo Barbara, Destro Annarita, Morenghi Emanuela, Montorsi Marco, Torzilli Guido, Tommasini Maurizio, Terracciano Luigi, Tornillo Luigi, Vecchione Raffaella, Roncalli Massimo
机构信息
Department of Pathology, University of Milan School of Medicine and IRCCS Humanitas Clinical Institute, Rozzano, Milan, Italy, and Institute of Pathology, University Hospital Basel, Switzerland.
出版信息
Hepatology. 2007 Mar;45(3):725-34. doi: 10.1002/hep.21531.
UNLABELLED
Hepatocellular nodules in cirrhosis include regenerative (large regenerative, LRN) and dysplastic (low and high grade, LGDN and HGDN) nodules, early and grade 1 HCC (eHCC-G1), and overt HCC. The differential diagnosis may be particularly difficult when lesions such as HGDN and eHCC-G1 are involved. We investigated the diagnostic yield of a panel of 3 putative markers of hepatocellular malignancy such as HSP70, glypican 3 (GPC3), and glutamine synthetase (GS). We selected 52 surgically removed nonmalignant nodules (15 LRNs, 15 LGDNs, 22 HGDNs) and 53 HCCs (10 early, 22 grade 1, and 21 grade 2-3) and immunostained them for HSP70, GPC3, and GS. The sensitivity and specificity of the individual markers for the detection of eHCC-G1 were 59% and 86% for GS, 69% and 91% for GPC3, and 78% and 95% for HSP70. We identified 2 main phenotypes: (1) all negative, seen in 100% LRN and LGDN, 73% HGDN and 3% eHCC-G1; (2) all positive, a feature detected in less than half the eHCC-G1. Using a 3-marker panel, when at least 2 of them, regardless which, were positive, the sensitivity and specificity for the detection of eHCC-G1 were respectively 72% and 100%; the most sensitive combination was HSP70+/GPC3+ (59%) when a 2-marker panel was used.
CONCLUSION
The adopted panel of 3 markers is very helpful in distinguishing eHCC-G1 from dysplastic nodules arising in cirrhosis.
未标注
肝硬化中的肝细胞结节包括再生性（大再生结节，LRN）和发育异常性（低级别和高级别，LGDN和HGDN）结节、早期和1级肝细胞癌（eHCC-G1）以及明显的肝细胞癌。当涉及HGDN和eHCC-G1等病变时，鉴别诊断可能特别困难。我们研究了一组3种假定的肝细胞恶性肿瘤标志物（如热休克蛋白70（HSP70）、磷脂酰肌醇蛋白聚糖3（GPC3）和谷氨酰胺合成酶（GS））的诊断效能。我们选取了52个手术切除的非恶性结节（15个LRN、15个LGDN、22个HGDN）和53个肝细胞癌（10个早期、22个1级和21个2 - 3级），并对它们进行HSP70、GPC3和GS免疫染色。GS检测eHCC-G1的个体标志物的敏感性和特异性分别为59%和86%，GPC3为69%和91%，HSP70为78%和95%。我们确定了2种主要表型：（1）全部阴性，见于100%的LRN和LGDN、73%的HGDN和3%的eHCC-G1；（2）全部阳性，在不到一半的eHCC-G1中检测到的特征。使用3种标志物组合时，无论哪2种标志物至少有1种为阳性，检测eHCC-G1的敏感性和特异性分别为72%和100%；使用2种标志物组合时，最敏感的组合是HSP70+/GPC3+（59%）。
结论
采用的3种标志物组合在区分肝硬化中出现的eHCC-G1与发育异常结节方面非常有帮助。
Zotero 插件