Kakar Sanjay, Gown Allen M, Goodman Zachary D, Ferrell Linda D
Department of Pathology, Veteran Affairs and University of California Medical Center, San Francisco, CA 94121, USA.
Arch Pathol Lab Med. 2007 Nov;131(11):1648-54. doi: 10.5858/2007-131-1648-BPIDIH.
Immunohistochemistry plays a crucial role in the diagnosis of hepatocellular carcinoma and in its distinction from other primary and metastatic neoplasms. Because limited tissue is available with fine-needle and core biopsies, appropriate selection of antibodies is imperative.
To review the antibodies used for the diagnosis of hepatocellular carcinoma and to outline an immunohistochemical approach in commonly encountered clinical situations.
Our experience and review of research articles published in the English literature between 1987 and 2006.
Hep Par 1 and polyclonal carcinoembryonic antigen are the most reliable markers for hepatocellular differentiation, but they have low sensitivity for poorly differentiated cases. Immunohistochemistry for glypican-3 shows promise for the diagnosis of poorly differentiated hepatocellular carcinoma and for its distinction from benign processes such as hepatic adenoma. Further studies with a large number of cases are required before it can be widely used. The combination of Hep Par 1 and MOC-31 will allow for the diagnosis of hepatocellular carcinoma in most cases and will guide the selection of immunohistochemical markers for further workup.
免疫组织化学在肝细胞癌的诊断及其与其他原发性和转移性肿瘤的鉴别中起着关键作用。由于细针穿刺活检和粗针穿刺活检所获得的组织有限，因此必须正确选择抗体。
回顾用于肝细胞癌诊断的抗体，并概述在常见临床情况下的免疫组织化学方法。
我们的经验以及对1987年至2006年间发表在英文文献中的研究文章的综述。
Hep Par 1和多克隆癌胚抗原是肝细胞分化最可靠的标志物，但对低分化病例的敏感性较低。磷脂酰肌醇蛋白聚糖-3免疫组织化学在低分化肝细胞癌的诊断及其与肝腺瘤等良性病变的鉴别方面显示出前景。在其能够被广泛应用之前，还需要对大量病例进行进一步研究。Hep Par 1和MOC-31联合使用将能够在大多数情况下诊断肝细胞癌，并指导选择免疫组织化学标志物进行进一步检查。
