D'Errico A, Baccarini P, Fiorentino M, Ceccarelli C, Bonazzi C, Ponzetto A, Scoazec J Y, Mancini A M, Grigioni W F
Institute of Pathological Anatomy, Department of Internal Medicine, University of Bologna, Italy.
Hum Pathol. 1996 Jun;27(6):599-604. doi: 10.1016/s0046-8177(96)90169-0.
To assess the utility of cytokeratin (CK) profile and albumin mRNA detection (as revealed by in situ hybridization) in the differential diagnosis of primary liver carcinomas (PLCs) we evaluated a series of surgically resected PLCs, comprising 20 "pure" hepatocellular carcinomas (HCCs) (10 well-differentiated, 10 poorly differentiated), 15 cholangiocarcinomas (CCs) (6 peripheral, 5 hilar, and 4 major duct ones) and 10 hepatocholangio-carcinomas (HCC-CCs). 11 of 20 (55%) of the pure HCCs expressed CKs of pure hepatocytic lineage (CK 8 and CK 18); 2 of 10 (20%) of the HCC-CCs displayed only hepatocytic profile, whereas 12 of 15 (80%) of the CCs evidenced mature bile duct cell phenotype (CK 8, CK 18, CK 7, CK 19). All HCCs expressed varying distributions of albumin mRNA, whereas 4 of 6 (67%) peripheral CCs showed cells with focal positivity for albumin mRNA. This suggests that the phenotypic expression of PLC cells are often not fixed, and in particular: (1) peripheral CCs have a different phenotype from hilar and large duct ones; (2) the CK profile and albumin mRNA expression in peripheral CCs show many similarities with those of some HCCs. Furthermore, the results show that a mixed biological phenotype (ie, CK 8, CK 18 and CK 7 and/or CK 19) can be found both among morphologically pure HCCs and peripheral CCs, suggesting that these two forms could share a common histogenesis. We think that special attention should be given to cases in which CK profile and albumin mRNA reveal mixed phenotype, as these tumors could have different biological behavior and respond differently to therapy.
为评估细胞角蛋白（CK）谱和白蛋白mRNA检测（通过原位杂交显示）在原发性肝癌（PLC）鉴别诊断中的作用，我们评估了一系列手术切除的PLC，包括20例“纯”肝细胞癌（HCC）（10例高分化，10例低分化）、15例胆管癌（CC）（6例周围型、5例肝门型和4例主胆管型）和10例肝内胆管癌（HCC-CC）。20例纯HCC中有11例（55%）表达纯肝细胞谱系的CK（CK 8和CK 18）；10例HCC-CC中有2例（20%）仅表现出肝细胞谱，而15例CC中有12例（80%）表现出成熟胆管细胞表型（CK 8、CK 18、CK 7、CK 19）。所有HCC均表达不同分布的白蛋白mRNA，而6例周围型CC中有4例（67%）显示细胞白蛋白mRNA局灶阳性。这表明PLC细胞的表型表达通常不固定，特别是：（1）周围型CC与肝门型和主胆管型CC的表型不同；（2）周围型CC的CK谱和白蛋白mRNA表达与某些HCC有许多相似之处。此外，结果表明，在形态学上纯的HCC和周围型CC中均可发现混合生物学表型（即CK 8、CK 18和CK 7和/或CK 19），提示这两种类型可能具有共同的组织发生学。我们认为，对于CK谱和白蛋白mRNA显示混合表型的病例应给予特别关注，因为这些肿瘤可能具有不同的生物学行为，对治疗的反应也不同。
