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半乳糖凝集素-3免疫组化、临床特征及肝脏影像学检查在鉴别肝内胆管癌与肝转移性腺癌中的意义

The significance of galectin-3 immunohistochemistry, clinical characteristics and liver imaging in differentiating intrahepatic cholangiocarcinoma from adenocarcinoma liver metastasis.

作者信息

Dechaphunkul Arunee, Kanngurn Samornmas, Dechsukhum Chavaboon, Tanutit Pramot, Khow-Ean Uthai, Sunpaweravong Patrapim

机构信息

Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

出版信息

J Med Assoc Thai. 2010 May;93(5):523-8.

Abstract

OBJECTIVE

To identify differences of Galectin-3 (Gal-3) immunostaining, clinical profiles, and images in patients with intrahepatic cholangiocarcinoma (IHC) and adenocarcinoma liver metastasis, and be able to recognize these parameters as diagnostic tools for differentiating these two diseases.

MATERIAL AND METHOD

Histological slides from patients with IHC and adenocarcinoma liver metastasis were reviewed Immunohistochemical staining for Gal-3, Cytokeratin-7 (CK-7), and Cytokeratin-20 (CK-20) was performed and the results categorized. Moreover clinical characteristics and liver images of the patients were reviewed.

RESULTS

Eighty-two patients were evaluated, 31 IHC and 51 adenocarcinoma liver metastasis. Patients who strongly expressed Gal-3 were positive for CK-7 and negative for CK-20. Finding showed that 86% of them were IHC whereas only 14% were in adenocarcinoma liver metastasis. All patients with liver images showing a single lesion, located at central site, and having intrahepatic duct dilatation were IHC. On the other hand, 77% of patients with liver imaging showing multiple liver masses, located at peripheral site and having no intrahepatic duct dilatation were adenocarcinoma liver metastasis while only 23% were in IHC.

CONCLUSION

Adding Gal-3 to CK-7 and CK-20 immunohistochemistry has benefits to differentiate IHC from adenocarcinoma liver metastasis. Furthermore, liver imaging profiles also give benefits for differentiating between these two diseases.

摘要

目的

鉴别肝内胆管癌(IHC)和腺癌肝转移患者中半乳糖凝集素-3(Gal-3)免疫染色、临床特征及影像学表现的差异,并能够将这些参数作为鉴别这两种疾病的诊断工具。

材料与方法

回顾性分析IHC和腺癌肝转移患者的组织学切片。进行Gal-3、细胞角蛋白-7(CK-7)和细胞角蛋白-20(CK-20)的免疫组织化学染色,并对结果进行分类。此外,还回顾了患者的临床特征和肝脏影像学表现。

结果

共评估了82例患者,其中31例为IHC,51例为腺癌肝转移。Gal-3强表达的患者CK-7阳性,CK-20阴性。结果显示,其中86%为IHC,而腺癌肝转移仅占14%。所有肝脏影像学表现为单个病灶、位于中央部位且伴有肝内胆管扩张的患者均为IHC。另一方面,肝脏影像学表现为多个肝肿块、位于周边部位且无肝内胆管扩张的患者中,77%为腺癌肝转移,而IHC仅占23%。

结论

在CK-7和CK-20免疫组织化学检查中加入Gal-3有助于鉴别IHC和腺癌肝转移。此外,肝脏影像学表现也有助于区分这两种疾病。

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