GPC3、GS、HSP70在肝细胞癌中的表达及意义

Expression of GPC3,GS,HSP70 in hepatocelluar carcinoma

目的研究免疫组织化学套餐磷脂酰肌醇蛋白聚糖-3(glypican-3,GPC3)、热休克蛋白70(heat shock protein70,HSP70)、谷氨酰胺合成酶(glutamyne synthetase,GS)在肝细胞癌(HCC)诊断中的应用。方法对85例HCC进行组织学观察,病理学分级;免疫组织化学方法检测上述病例中GPC3、GS、HSP70的表达情况。结果 85例HCC病例中,GPC3阳性表达率为88.24%(75/85),GPC3在肝细胞癌的阳性表达率随着分化的升高而递增,高分化与中低分化者GPC3的表达差异有统计学意义,与分化程度相关,其中7例可见癌旁再生结节个别细胞阳性表达;85例中80例HSP70均有不同程度的阳性表达,与HCC分化无明显相关,3例癌周组织中可见汇管区周围肝细胞着色;GS在HCC及周围肝组织的表达方式不同,HCC中有67.06%(57/85)阳性表达,GS的阳性表达与分化无明显相关性。结论 HSP70、GS、GPC3 3个指标的应用对于HCC的诊断具有各自的优点和缺点,在日常工作中,需在HE形态学基础上,结合上述3个指标的分布特点和表达强弱综合评估,免疫组化指标的应用可以进一步提高HCC诊断的可靠性。

Objective To evaluate the application of Glypican 3（GPC3）,heat shock protein 70（HSP70） and glutamine synthetase（GS） in hepatocellular carcinoma.Methods Morphology of 85 cases of HCC were evaluated;three immunohistochemical markers-GPC3,GS,HSP70 were detected in these cases.Results In the 85 HCC cases,GPC3 was positive in 88.24%（75/85） cases and its expression was higher in poorly differentiation HCC than that in well/moderately differentiated HCC,the expression difference was statistically significant,individual cells in regenerative nodules adjacent HCC were GPC3 positive in 7 HCC;HSP70 was positive in 94.12%（80/85） cases,their expression had no significant correlation with HCC differentiation,and individual cells in regenerative nodules adjacent HCC were positive in 3 HCC;GS expression had different distribution modes between HCC and surrounding liver tissues,GS was positive in 67.06%（57/85） HCC and its expression had no significant correlation with HCC differentiation.Conclusion HSP70,GS,GPC3 for the diagnosis of HCC have their own advantages and disadvantages respectively.In daily work,diagnosis should base on HE morphology,and application of a panel of immunohistochemistry markers which can further improve the reliability of HCC diagnosis.