Honsová Eva, Lodererová Alena, Franková Sona, Oliverius Martin, Trunecka Pavel
Institute for Clinical and Experimental Medicine Prague, Department of Clinical and Transplant Pathology, Czech Republic.
Cas Lek Cesk. 2011;150(1):37-40.
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors which occur mainly in patients with chronic liver disease. Early detection of HCC is critically important for treatment of the patients. However, most early HCC cases are asymptomatic clinically with the lack of typical radiological findings. Also histological diagnosis is often very difficult with the lack of agreement even among expert pathologists.
We studied the expression of Glypican-3 in 138 liver biopsy samples; 86 HCC, 10 hepatocellular adenomas, 12 focal nodular hyperplasias, 25 samples with liver cirrhosis without tumor, and 5 liver metastases of neuroendocrine carcinomas.
HCC showed positive staining in 80 nodules (93%; all of the 11 needle biopsy samples, 12 out of 15 liver resection specimens, 57 out of 60 nodules in explanted livers). Glypican-3 expression was independent of the differentiation and size of the HCC. Six cases (6.9%), 3 HCC in liver resection specimens and 3 in the explanted liver were negative for Glypican-3. However, all cases with benign nodular lesions and cirrhosis without tumors were negative for Glypican-3.
Immunohistochemical detection of Glypican-3 significantly improves the complicated routine histological diagnosis of HCC even in early lesions in needle biopsy samples.
肝细胞癌（HCC）是最常见的恶性肿瘤之一，主要发生于慢性肝病患者。早期发现HCC对患者的治疗至关重要。然而，大多数早期HCC病例临床上无症状，缺乏典型的影像学表现。而且组织学诊断通常也非常困难，即使在专家病理学家之间也缺乏一致性。
我们研究了138例肝活检样本中Glypican-3的表达情况；其中86例为HCC，10例为肝细胞腺瘤，12例为局灶性结节性增生，25例为无肿瘤的肝硬化样本，5例为神经内分泌癌肝转移样本。
80个结节的HCC呈阳性染色（93%；11例针吸活检样本全部阳性，15例肝切除标本中有12例阳性，60例移植肝结节中有57例阳性）。Glypican-3的表达与HCC的分化程度和大小无关。6例（6.9%），肝切除标本中的3例HCC和移植肝中的3例HCC对Glypican-3呈阴性。然而，所有良性结节性病变和无肿瘤的肝硬化病例对Glypican-3均呈阴性。
Glypican-3的免疫组化检测显著改善了HCC复杂的常规组织学诊断，即使在针吸活检样本的早期病变中也是如此。
