增强子结合锌指蛋白 2（EZH2）是一种可靠的免疫组化标志物，可用于鉴别良恶性肝肿瘤。
Enhancer of zeste homologue 2 (EZH2) is a reliable immunohistochemical marker to differentiate malignant and benign hepatic tumors.
机构信息
First Department of Pathology and Experimental Cancer Research, Semmelweis University, Üllõi út 26, Budapest, H-1085, Hungary.
出版信息
Diagn Pathol. 2012 Jul 18;7:86. doi: 10.1186/1746-1596-7-86.
BACKGROUND
The immunohistochemical demonstration of Enhancer of zeste homologue 2 (EZH2) proved to be a useful marker in several tumor types. It has been described to distinguish reliably hepatocellular carcinomas from liver adenomas and other benign hepatocellular lesions. However, no other types of malignant liver tumors were studied so far.
METHODS
To evaluate the diagnostic value of this protein in hepatic tumors we have investigated the presence of EZH2 by immunohistochemistry in hepatocellular carcinomas and other common hepatic tumors.EZH2 expression was examined in 44 hepatocellular carcinomas, 23 cholangiocarcinomas, 31 hepatoblastomas, 16 other childhood tumor types (rhabdomyosarcoma, neuroblastoma, Wilms' tumor and rhabdoid tumor), 17 metastatic liver tumors 24 hepatocellular adenomas, 15 high grade dysplastic nodules, 3 biliary cystadenomas, 3 biliary hamartomas and 3 Caroli's diseases.
RESULTS
Most of the malignant liver tumors were positive for EZH2, but neither of the adenomas, cirrhotic/dysplastic nodules, reactive and hamartomatous biliary ductules stained positively.
CONCLUSIONS
Our immunostainings confirm that EZH2 is a sensitive marker of hepatocellular carcinoma, but its specificity is very low, since almost all the investigated malignant liver tumors were positive regardless of their histogenesis. Based on these results EZH2 is a sensitive marker of malignancy in hepatic tumors. In routine surgical pathology EZH2 could be most helpful to diagnose cholangiocarcinomas, because as far as we know this is the first marker to distinguish transformed and reactive biliary structures. Although hepatoblastomas also express EZH2, the diagnostic significance of this observation seems to be quite limited whereas, the structurally similar, other blastic childhood tumors are also positive.
VIRTUAL SLIDES
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1173195902735693.
背景
EZH2（ Enhancer of zeste homologue 2）免疫组化表现已被证明是多种肿瘤类型的有用标志物。它已被描述为能够可靠地区分肝细胞癌与肝腺瘤和其他良性肝细胞病变。然而，目前还没有研究其他类型的恶性肝肿瘤。
方法
为了评估该蛋白在肝肿瘤中的诊断价值，我们通过免疫组化法检测了 EZH2 在肝细胞癌和其他常见肝肿瘤中的表达。EZH2 的表达在 44 例肝细胞癌、23 例胆管细胞癌、31 例肝母细胞瘤、16 例其他儿童肿瘤类型（横纹肌肉瘤、神经母细胞瘤、Wilms 瘤和横纹肌肉瘤）、17 例转移性肝肿瘤、24 例肝细胞腺瘤、15 例高级别异型增生结节、3 例胆管囊腺瘤、3 例胆管错构瘤和 3 例 Caroli 病中进行了检测。
结果
大多数恶性肝肿瘤 EZH2 阳性，但腺瘤、肝硬化/异型增生结节、反应性和错构性胆管均未染色。
结论
我们的免疫组化染色证实，EZH2 是肝细胞癌的敏感标志物，但特异性非常低，因为几乎所有研究的恶性肝肿瘤均为阳性，而不管其组织发生。基于这些结果，EZH2 是肝肿瘤恶性的敏感标志物。在常规外科病理学中，EZH2 最有助于诊断胆管细胞癌，因为据我们所知，这是区分转化和反应性胆道结构的第一个标志物。尽管肝母细胞瘤也表达 EZH2，但这一观察结果的诊断意义似乎相当有限，而结构相似的其他成骨性儿童肿瘤也是阳性的。
虚拟幻灯片
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