Volpes R, van den Oord J J, Desmet V J
Department of Pathology, University Hospital Sint-Rafaël, Catholic University of Leuven, Belgium.
Am J Pathol. 1993 May;142(5):1483-92.
This study analyzed new cell lineage markers for the differential diagnosis between hepatocellular carcinoma (HCC) and cholangiocarcinoma (ChC), as well as the potential pathways of cell-cell and cell-extracellular matrix interactions of neoplastic liver cells during tumor spread and invasion, by comparing the expression of (VLA) integrins, vitronectin receptor, and neural cell adhesion molecule in normal, inflamed, and neoplastic human liver biopsies. All cases of liver cell adenoma and well-differentiated HCC expressed the same set of integrins as observed in normal liver tissue, i.e., VLA-alpha 1 and VLA-beta 1. Poorly differentiated HCC also expressed VLA-alpha 1 and VLA-beta 1, but in addition de-novo expressed VLA-alpha 2, VLA-alpha 3, VLA-alpha 6 and vitronectin receptor. All cases of well-differentiated ChC expressed an identical integrin immunoprofile as observed in normal bile duct epithelium, i.e., VLA-alpha 2, VLA-alpha 3, VLA-alpha 6, VLA-beta 4 and vitronectin receptor, whereas poorly differentiated ChC showed a markedly decreased expression of these integrin subunits. VLA-alpha 1 was constantly absent from all cases of ChC, whereas VLA-beta 4 was never expressed by HCC. Neural cell adhesion molecule, exclusively expressed by proliferating reactive bile ductules in cholestatic and regenerating liver, was constantly absent from both malignant neoplasms. In conclusion, the integrin make up of various liver tumors closely follows that of their normal counterparts. Differences in integrin receptor expression vary according to the cellular origin of the tumors and are associated with a poor differentiation. Our findings suggest that immunohistochemical staining for VLA-alpha 1 and VLA-beta 4 integrin subunits, which highlight the cellular phenotype of the two neoplasms, might be a helpful tool in the differential diagnosis between HCC and ChC.
本研究通过比较正常人肝脏活检组织、炎症肝脏活检组织及肿瘤肝脏活检组织中(VLA)整合素、玻连蛋白受体和神经细胞黏附分子的表达,分析了用于肝细胞癌(HCC)和胆管癌(ChC)鉴别诊断的新细胞谱系标志物,以及肿瘤扩散和侵袭过程中肿瘤性肝细胞的细胞 - 细胞和细胞 - 细胞外基质相互作用的潜在途径。所有肝细胞腺瘤和高分化HCC病例表达的整合素与正常肝组织中观察到的相同,即VLA-α1和VLA-β1。低分化HCC也表达VLA-α1和VLA-β1,但此外还新表达了VLA-α2、VLA-α3、VLA-α6和玻连蛋白受体。所有高分化ChC病例表达的整合素免疫表型与正常胆管上皮中观察到的相同,即VLA-α2、VLA-α3、VLA-α6、VLA-β4和玻连蛋白受体,而低分化ChC显示这些整合素亚基的表达明显降低。所有ChC病例中均始终不存在VLA-α1,而HCC从未表达VLA-β4。神经细胞黏附分子仅在胆汁淤积和再生肝脏中增殖的反应性胆小管中表达,在这两种恶性肿瘤中均始终不存在。总之,各种肝肿瘤的整合素组成与其正常对应物密切相关。整合素受体表达的差异根据肿瘤的细胞起源而变化,并与低分化相关。我们的研究结果表明,对VLA-α1和VLA-β4整合素亚基进行免疫组化染色可突出这两种肿瘤的细胞表型,可能是HCC和ChC鉴别诊断的有用工具。