Nascimento C, Caroli-Bottino A, Paschoal J, Pannain V L
Federal University of Rio de Janeiro, Department of Pathology, Rua Prof. Rodolpho Paulo Rocco, 255--CEP: 21941-913 Rio de Janeiro, Brazil.
Transplant Proc. 2009 Dec;41(10):4211-3. doi: 10.1016/j.transproceed.2009.09.068.
The process of hepatic carcinogenesis involves a progression including large regenerative nodules, to dysplastic nodules, and finally to hepatocellular carcinoma. Angiogenesis is fundamental to the development of malignant tumors. Changes in sinusoidal capillarization and isolated arteries occur early in hepatic carcinogenesis. However, sometimes differentiation of hepatocellular nodules can be difficult for the general pathologist. The aim of this study was to evaluate angiogenesis by immunohistochemistry using CD34 and HHF35 antibodies for differential diagnosis of large regenerative nodules versus dysplastic nodules versus hepatocellular carcinoma using explanted cirrhotic livers.
Seventy-nine nodules obtained from 29 explanted cirrhotic livers were classified according to the International Working Party as follows: 17 large regenerative, 23 low-grade dysplastic, 23 high-grade dysplastic, and 16 hepatocellular carcinomas. These nodules were submitted to immunohistochemistry with antibodies to CD34 and HHF35 to analyze sinusoidal capillarization and arterialization, respectively.
Semiquantitative analysis revealed that CD34 expression was >30% in dysplastic nodules and hepatocellular carcinoma; the staining in 93.8% of cases was diffuse, almost involving the entire sinusoidal lining in hepatocellular carcinoma. The number of isolated arteries was high in hepatocellular carcinoma (average, 4.369), which positively correlated with the other nodules (P < .005).
Quantification of sinusoidal capillarization and isolated arteries in hepatocellular nodules, as detected with CD34 and HHF35 antibodies, respectively provided an important tool to differentiate dysplastic nodules from hepatocellular carcinoma.
肝癌发生过程涉及一个进展过程，包括大再生结节、发育异常结节，最终发展为肝细胞癌。血管生成是恶性肿瘤发展的基础。肝窦毛细血管化和孤立动脉的改变在肝癌发生早期就会出现。然而，对于普通病理学家来说，有时肝细胞结节的鉴别可能会很困难。本研究的目的是通过免疫组织化学方法，使用CD34和HHF35抗体评估血管生成，以对移植的肝硬化肝脏中的大再生结节、发育异常结节和肝细胞癌进行鉴别诊断。
从29例移植的肝硬化肝脏中获取79个结节，根据国际工作组织进行如下分类：17个大再生结节、23个低级别发育异常结节、23个高级别发育异常结节和16个肝细胞癌。这些结节分别用抗CD34和HHF35抗体进行免疫组织化学分析，以分别分析肝窦毛细血管化和动脉化情况。
半定量分析显示，发育异常结节和肝细胞癌中CD34表达>30%；93.8%的肝细胞癌病例染色呈弥漫性，几乎累及整个肝窦内衬。肝细胞癌中孤立动脉数量较多（平均为4.369），与其他结节呈正相关（P <.005）。
分别用CD34和HHF35抗体检测肝细胞结节中的肝窦毛细血管化和孤立动脉数量，为鉴别发育异常结节和肝细胞癌提供了一个重要工具。
