Chen X Y, Dong L, Wang C F
Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Zhonghua Bing Li Xue Za Zhi. 2022 May 8;51(5):400-406. doi: 10.3760/cma.j.cn112151-20210816-00573.
To investigate the utility of albumin RNAscope in situ hybridization in the diagnosis and differential diagnosis of hepatocellular carcinoma and its mimics. One hundred and fifty-two cases of hepatocellular carcinoma and its mimics and 33 cases of normal tissue were selected from the pathology database of the Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2013 to December 2019. Tissue microarrays were constructed and RNAscope in situ hybridization was performed to detect the expression of albumin mRNA. No albumin mRNA expression was detected in normal tissues except for the liver. All hepatocellular carcinoma regardless of its degree of differentiation and primary or metastatic nature had detectable albumin mRNA, with strong and diffuse staining in 90.7% (49/54) of cases. While the positive rate of HepPar-1, Arg-1 or one of them by immunohistochemistry was 87.0% (47/54), 85.2% (46/54) and 92.6% (50/54) respectively. The positive rates of albumin mRNA in intrahepatic cholangiocarcinoma and biphenotypic hepatocellular carcinoma were 7/15 and 9/10, respectively. The former showed focal or heterogeneous staining, while the latter showed strong and diffuse staining. The positive rate of hepatoid adenocarcinoma was 8/19, and the albumin expression could be diffuse or focal. Sporadic cases of poorly differentiated gastric adenocarcinoma and metastatic colon adenocarcinoma showed focal staining of albumin mRNA. Detection of albumin mRNA by RNAscope in situ hybridization is of great value for the diagnosis and differential diagnosis of HCC, and the sensitivity may be improved by combining with HepPar-1 and Arg-1. It also offers different diagnostic clues according to different expression patterns.
探讨白蛋白RNAscope原位杂交技术在肝细胞癌及其相似病变诊断与鉴别诊断中的应用价值。选取2013年1月至2019年12月上海交通大学医学院附属瑞金医院病理科病理数据库中的152例肝细胞癌及其相似病变和33例正常组织。构建组织芯片并进行RNAscope原位杂交检测白蛋白mRNA的表达。除肝脏外，正常组织未检测到白蛋白mRNA表达。所有肝细胞癌，无论其分化程度及原发或转移性质，均检测到白蛋白mRNA，90.7%（49/54）的病例呈强弥漫性染色。免疫组化检测HepPar-1、Arg-1或其中之一的阳性率分别为87.0%（47/54）、85.2%（46/54）和92.6%（50/54）。肝内胆管癌和双相型肝细胞癌中白蛋白mRNA的阳性率分别为7/15和9/10。前者呈局灶性或异质性染色，后者呈强弥漫性染色。肝样腺癌的阳性率为8/19，白蛋白表达可为弥漫性或局灶性。散发性低分化胃腺癌和转移性结肠腺癌病例显示白蛋白mRNA局灶性染色。RNAscope原位杂交检测白蛋白mRNA对肝细胞癌的诊断和鉴别诊断具有重要价值，联合HepPar-1和Arg-1可能提高敏感性。其还根据不同表达模式提供不同的诊断线索。
