摘要
[目的]探讨甲胎蛋白(AFP)阴性的肝细胞肝癌(hepatocellularcarcinoma,HCC)的病理形态特点及鉴别诊断。[方法]观察和分析5例HCC的临床和病理组织学特点及免疫组和染色结果。[结果]5例中女2例,男3例,年龄50~69(中位年龄58.8)岁。临床表现病毒性肝炎、肝硬化及肝部占位并血清AFP检测值阴性。光镜下癌细胞密度增加,肝板细胞层数增多,排列呈条索状、小梁状、实性巢团状,小梁周围为扩张不规则的肝窦,癌细胞大小不一,异型性明显,细胞胞浆嗜酸核分裂像易见。免疫组化:5例AFP、CD10、CK7、CK20、GCDFP15、ER、PR、CK19、CDX-2、CEA均为阴性,CD34、VIllin均为阳性,Heppaxl 3例阳性、1例阴性、1例点灶阳性。[结论]APF阴性的HCC是少见病理类型,结合其临床症状、部位、组织病理特点和免疫组化标记可确定诊断。
[Objective]To observe the clinicopathologic features and differential diagnosis of hepatocellu- lar carcinoma with negative alpha fetal protein(AFT). [Methods]The clinical and pathologic profiles of 5 cases were retrospectively analyzed. [Results]The age of patients ranged from 50 to 69 years(mean 58.8 years), 2 patients were female and 3 patients were male. The clinical manifestations were viral hepatitis,liv- er cirrhosis,liver mass and combined with normal serum AFP value. Microscopically, the density of tumor cells and the cellff layers of hepatic plates increased. The tumor cells arranged streak,trabecular and nests, with dilated and irregular sinus hepaticus around trabecular cells. The tumor cells were different size,obvi- ous atypia and oxyphilous cytoplasm, and the mitotic figures were easy to found. Immunohistochemically, the tumor cells were all negative for AFP, CD10, CK7, CK20, GCDFP15, ER, PR, CK19, CDX-2, CEA and positive for CD34, VIllin, had Hep pax1 with one negative case, three positive cases and one positive spotted case. [Conclusion]The hepatocellular carcinoma with negative ADP is a rare pathological type. It can make an accurate diagnosis by integrating the clinical symptoms and location with histopathological features and immunohistochemical markers.
出处
《临床消化病杂志》
2016年第2期81-84,共4页
Chinese Journal of Clinical Gastroenterology
关键词
肝细胞肝癌
甲胎蛋白
病理诊断
免疫组化
hepatocellular carcinoma
alpha fetoprotein
pathological diagnosis
immunohistochemistry