磷脂酰肌醇蛋白聚糖-3的表达在肝细胞癌诊断中的意义

Significance of glypican-3 immunohistochemistry in diagnosis of hepatocellular carcinoma

目的 探讨磷脂酰肌醇蛋白聚糖-3（ GPC3）免疫组织化学染色在肝细胞癌病理诊断的应用价值。方法 制作14个含731例肝肿瘤和肿瘤旁肝组织芯片，其中肝细胞癌357例、胆管癌26例、肝细胞癌癌旁肝组织包括肝硬化171例、血管瘤旁肝组织93例、肝转移癌84例。全部病例采用免疫组织化学检测GPC3（1G12克隆）蛋白表达，实验设阳性对照。结果 72.0％的肝细胞癌（257/357）GPC3呈阳性反应，其余374例非肝细胞癌病例均为阴性，包括胆管癌、肝转移癌、肝细胞癌癌旁肝组织（包括肝硬化和血管瘤旁肝组织）。GPC3阳性率在不同的肝细胞癌组织学分级的差异有统计学意义（P＜0.01），阳性率高低排列为Ⅲ级（77.1％，64/83）、Ⅱ级（73.3％，187/255）、Ⅰ级6/12和Ⅳ级（0）为阴性。结论 GPC3免疫组织化学检测是肝细胞癌诊断的良好指标，敏感性达72.0％；也是区别瘤旁肝组织和肝转移癌的鉴别诊断指标，其特异性达100％。

ObjectiveTo explore the diagnostic significance of glypican-3 （GPC3）immunohistochemistry in hepatocellular carcinoma （HCC）. Methods Fourteen tissue microarray paraffin blocks were constructed, which comprised 731 samples from hepatic tumors and paratumor tissues, including 357 cases of HCC, 26 cholangiocarcinoma, 171 HCC adjacent hepatic tissue including cirrhosis,93 hemangioma adjacent hepatic tissues, and 84 carcinomas metastatic to liver. GPC3 （Clone 1G12） protein was detected immunohistochemically in all of cases with positive controls. Results GPC3 protein was positive in 72. 0% HCC （257/357）, but negative in the rest 374 of non-HCC cases, including cholangiocarcinoma, HCC adjacent hepatic tissue including cirrhosis, hemangioma adjacent hepatic tissues and metastatic carcinomas. GPC3 positive percentage was significantly correlated with histological grading of HCC （P 〈0. 01 ）, highest in grade 3 （77. 1% ,64/83 ） followed by grade 2 （ 73. 3%, 187/255 ）, grade 1（6/12） and grade4 （0）. Conclusions GPC3 is a valuable diagnostic marker for hepatocellular carcinoma with sensitivity of 72. 0%, and a differential diagnostic marker from tumor adjacent hepatic tissue and carcinomas metastatic to liver with specificity of 100%.