DU Jing-li, Wei Li-xin, Wang Yu-lan
Department of Pathology, the General Hospital of PLA, Beijing 100853, China.
Zhonghua Bing Li Xue Za Zhi. 2011 Jan;40(1):11-6.
To study the expression and significance of GPC3, CD10 and CD34 in hepatocellular carcinoma (HCC), dysplastic nodules (DN), cirrhotic regenerative nodules (CRN), focal nodular hyperplasia (FNH) and hepatocellular adenoma (HA).
Immunohistochemical study for GPC3, CD10, CD34 and AFP was performed on 80 cases of HCC (30 cases of well-differentiated HCC and 50 cases of advanced HCC), 30 cases of DN (18 cases of high-grade DN and 12 cases of low-grade DN), 36 cases of CRN, 20 cases of FNH and 20 cases of HA.
(1) The positive expression rate of GPC3 was 92% (46/50) in advanced HCC, 66.7% (20/30) in well-differentiated HCC, 2/18 in high-grade DN, and 0 in low-grade DN, CRN, FNH and HA. The expression rate of GPC3 in well-differentiated HCC was lower than that in advanced HCC and higher than that in high-grade DN (P < 0.05). (2) The negative expression rate of CD10 was 78% (39/50) in advanced HCC, 43.3% (13/30) in well-differentiated HCC, 20% (4/20 and 4/20) in both FNH and HA, 2.8% (1/36) in CRN and 0 in both high-grade DN and low-grade DN. The occurrence of CD10-strongly positive cells was 2% (1/50) in advanced HCC, 16.7% (5/30) in well-differentiated HCC, 15/18 in high-grade DN, 11/12 in low-grade DN, 80.6% (29/36) in CRN and 60% (12/20 and 12/20) in both FNH and HA. The positive expression rate of CD10 in well-differentiated HCC was higher than that in advanced HCC and lower than that in high-grade DN, low-grade DN, CRN, FNH and HA (P < 0.05). (3) The positive expression rates of CD34 in advanced HCC and well-differentiated HCC ranged from 25% to 100% [and strongly positive in 76% (38/50) and 70% (21/30), respectively]. The rates in high-grade DN and low-grade DN ranged from 5% to 25% (and weakly positive in 16/18 and 10/12, respectively). In CRN, the rate ranged from 0 to 5% [and weakly positive in 27.8% (10/36)]. In FNH and HA, the positive rates ranged from 25% to 50%. The positive expression rate of CD34 in well-differentiated HCC was significantly higher than that in high-grade DN, low-grade DN, CRN, FNH and HA (P < 0.05). (4) The positive expression rate of AFP was 44% (22/50) in advanced HCC, 20% (6/30) in well-differentiated HCC, no expression in DN, LCN, LCN, FNH and HA. The positive expression rate of AFP in well-differentiated HCC was lower than that in advanced HCC and higher than that in LCN, FNH and HA. The different expression had statistical significance (P < 0.05).
GPC3 is a relatively sensitive and specific marker in pathologic diagnosis of HCC. When coupled with immunohistochemical results of CD34, CD10 and AFP, GPC3 is useful in differentiating HCC from DN, LCN, FNH and HA.
研究磷脂酰肌醇蛋白聚糖3（GPC3）、CD10和CD34在肝细胞癌（HCC）、发育异常结节（DN）、肝硬化再生结节（CRN）、局灶性结节性增生（FNH）和肝细胞腺瘤（HA）中的表达及意义。
对80例HCC（30例高分化HCC和50例进展期HCC）、30例DN（18例高级别DN和12例低级别DN）、36例CRN、20例FNH和20例HA进行GPC3、CD10、CD34和甲胎蛋白（AFP）的免疫组织化学研究。
（1）GPC3在进展期HCC中的阳性表达率为92%（46/50），在高分化HCC中为66.7%（20/30），在高级别DN中为2/18，在低级别DN、CRN、FNH和HA中为0。GPC3在高分化HCC中的表达率低于进展期HCC，高于高级别DN（P<0.05）。（2）CD10在进展期HCC中的阴性表达率为78%（39/50），在高分化HCC中为43.3%（13/30），在FNH和HA中均为20%（4/20和4/20），在CRN中为2.8%（1/36），在高级别DN和低级别DN中均为0。CD10强阳性细胞在进展期HCC中的发生率为2%（1/50），在高分化HCC中为16.7%（5/30），在高级别DN中为15/18，在低级别DN中为11/12，在CRN中为80.6%（29/36），在FNH和HA中均为60%（12/20和12/20）。CD10在高分化HCC中的阳性表达率高于进展期HCC，低于高级别DN、低级别DN、CRN、FNH和HA（P<0.05）。（3）CD34在进展期HCC和高分化HCC中的阳性表达率为25%至100%[分别在76%（38/50）和70%（21/30）中呈强阳性]。在高级别DN和低级别DN中的阳性率为5%至25%（分别在16/18和10/12中呈弱阳性）。在CRN中，阳性率为0至5%[在27.8%（10/36）中呈弱阳性]。在FNH和HA中，阳性率为25%至50%。CD34在高分化HCC中的阳性表达率显著高于高级别DN、低级别DN、CRN、FNH和HA（P<0.05）。（4）AFP在进展期HCC中的阳性表达率为44%（22/50），在高分化HCC中为20%（6/30），在DN中无表达，在CRN、FNH和HA中也无表达。AFP在高分化HCC中的阳性表达率低于进展期HCC，高于CRN、FNH和HA。不同表达具有统计学意义（P<0.05）。
GPC3是HCC病理诊断中相对敏感和特异的标志物。当与CD34、CD10和AFP的免疫组织化学结果相结合时，GPC3有助于将HCC与DN、CRN、FNH和HA区分开来。
