Glypican-3免疫組化在肝穿刺活檢肝細胞癌診斷的價值

The diagnostic value of glypican-3 immunohistochemistry for hepatocellular carcinoma in liver needle biopsy

目的磷脂醯肌醇蛋白聚糖-3(GPC3)是一種硫酸乙醯肝素蛋白聚糖,僅在肝細胞癌(hepatocel-lular carcinoma,HCC)患者的血清中升高,而在正常人和良性肝臟疾病患者無升高。本文探討GPC3免疫組化在肝穿刺活檢中診斷HCC的價值。方法採用免疫組化檢測41例HCC、7例肝局灶結節增生或局灶肝細胞異型增生、4例肝硬化、4例病毒性肝炎或未見病變肝組織、4例膽管癌、21例轉移癌GPC3(1G12克隆)表達,並設陽性和陰性對照。結果80.5%的HCC(33/41例)GPC3呈陽性反應。相反,40例非HCC肝穿刺病例,包括肝局灶結節增生或局灶肝細胞異型增生、肝硬化、病毒性肝炎或未見病變肝組織、膽管癌和轉移癌GPC3均為陰性。GPC3免疫組化檢測在肝穿刺活檢HCC診斷的敏感性和特異性分別為80.5%和100%。結論GPC3免疫組化是肝穿刺活檢診斷HCC的良好指針,也是區別其他肝臟良性疾病和轉移癌的鑒別診斷指針。

Objective Glypican 3(GPC3)is a heparan sulfate proteoglycan which is elevated in the serum of patients with hepatocellular carcinoma(HCC),but not in healthy blood donors,or patients with benign liver disease.This study explores the value of GPC3 expression for diagnosis of HCC in liver needle biopsy by immunohistochemistry.Methods Archival material in liver needle biopsies from 41 patients with HCC,7 focal nodular hyperplasia or focal liver cell dysplasia,4 cirrhosis,4 viral hepatitis or unremarkable liver tissue,4 cholangiocarcinoma,21 patients with metastatic tumors,were studied.All slides were stained with GPC3-1G12 antibody with appropriate positive and negative controls.Results In the HCC group,GPC3 positive staining was found in 33/41(80.5%)samples.In contrast,all 40 non-HCC cases of liver biopsies,including focal nodular hyperplasia or focal liver cell dysplasia,cirrhosis,viral hepatitis or unremarkable liver tissue,cholangiocarcinoma,and metastatic tumors,displayed negative staining.The sensitivity and specificity of GPC3 in HCC were 80.5%and 100%respectively.Conclusion GPC3 immunohistochemistry is a valuable diagnostic marker for hepatocellular carcinoma in liver needle biopsy.Thus,the diagnostic utility of GPC3 in liver needle biopsy aids in distinction of HCC from metastatic tumors and benign liver lesions.