Division of Anatomic Pathology, Mayo Clinic, Rochester, MN 55905, USA.
Hum Pathol. 2013 Apr;44(4):542-50. doi: 10.1016/j.humpath.2012.06.016. Epub 2012 Oct 15.
Glypican-3 (GPC3) is a plasma membrane-bound proteoglycan that can be overexpressed in certain malignancies but has been particularly linked to hepatocellular carcinoma (HCC). GPC3 is currently used as an immunohistochemical marker for HCC, but its expression in epithelial neoplasms of the gastrointestinal (GI) tract and pancreas, a common source of liver metastasis, has not been studied in detail. In this study, we examined GPC3 immunoreactivity in 98 neoplasms of the GI tract including 30 adenocarcinomas (ADCA), 29 squamous cell carcinomas (esophageal and anal), and 39 neuroendocrine carcinomas, and 60 neoplasms of the pancreas including 22 ADCA, 26 pancreatic neuroendocrine neoplasms, and 12 pancreatic acinar cell carcinomas. Two control groups of 32 HCCs and 16 intrahepatic cholangiocarcinomas were also stained with GPC3. Although most (7/12, 58.5%) acinar cell carcinomas were GPC3 positive, pancreatic ADCA and neuroendocrine neoplasms were GPC3 negative. In addition, 27.5%, (8/29) of squamous cell carcinomas, 20% (6/30) of ADCA, and 2.5% (1/39) of neuroendocrine carcinomas of the GI tract were immunoreactive for GPC3. HCC was positive for GPC3 in 75% (24/32) of cases but cholangiocarcinoma was negative. While significant correlation between GPC3 positivity and poor differentiation was observed in HCC only, GPC3 expression did not correlate with tumor size. In conclusion, 14% of GI tract and pancreatic carcinomas/neoplasms (particularly pancreatic acinar cell carcinoma) can express GPC3 by immunohistochemistry. As these tumors commonly metastasize to the liver, this offers a potential pitfall in differentiating between HCC and metastatic carcinoma when evaluating tumors involving the liver.
磷脂酰聚糖-3（GPC3）是一种质膜结合的蛋白聚糖，在某些恶性肿瘤中可过度表达，但与肝细胞癌（HCC）尤其相关。GPC3 目前被用作 HCC 的免疫组织化学标志物，但尚未详细研究其在胃肠道（GI）和胰腺上皮肿瘤中的表达，而这是肝脏转移的常见来源。在这项研究中，我们检查了 98 种 GI 道肿瘤包括 30 种腺癌（ADCA）、29 种鳞状细胞癌（食管和肛门）和 39 种神经内分泌癌，以及 60 种胰腺肿瘤，包括 22 种 ADCA、26 种胰腺神经内分泌肿瘤和 12 种胰腺腺泡细胞癌。还对两组 32 例 HCC 和 16 例肝内胆管癌进行了 GPC3 染色。尽管大多数（12 例中的 7 例，58.5%）腺泡细胞癌呈 GPC3 阳性，但胰腺 ADCA 和神经内分泌肿瘤呈 GPC3 阴性。此外，27.5%（29 例中的 8 例）的鳞状细胞癌、20%（30 例中的 6 例）的 ADCA 和 2.5%（39 例中的 1 例）的 GI 道神经内分泌癌对 GPC3 具有免疫反应性。HCC 中 GPC3 的阳性率为 75%（32 例中的 24 例），而胆管癌为阴性。虽然仅在 HCC 中观察到 GPC3 阳性与低分化之间存在显著相关性，但 GPC3 表达与肿瘤大小无关。总之，14%的 GI 道和胰腺肿瘤/肿瘤（特别是胰腺腺泡细胞癌）可以通过免疫组织化学方法表达 GPC3。由于这些肿瘤通常转移到肝脏，因此在评估涉及肝脏的肿瘤时，这可能会在区分 HCC 和转移性癌方面造成潜在的陷阱。
