文劍明 葉玉清 黃香婷
目的 探討磷脂酰肌醇蛋白聚糖-3(glypican-3, GPC3)免疫組化在肝細胞癌病理診斷的應用價值。
結果 72.0%的肝細胞癌(257/357例)GPC3呈陽性反應，其餘374例非肝細胞癌病例均為陰性，包括膽管癌、肝轉移癌、肝細胞癌癌旁肝組織包括肝硬化和血管瘤旁肝組織。GPC3陽性率在不同的肝細胞癌組織學分級的差異在統計學上有非常顯著性意義( p<0.01)，陽性率高低排列為III級(77.1%)、II級(73.3%)、I級(50%)和IV級(0%)為陰性。
Significance of GPC3 immunohistochemistry in diagnosis of hepatocellular carcinoma
WEN Jian-ming, YIP Yuk-ching, VONG Heong-ting
Department of Pathology, Kiang Wu Hospital, Macau; E-mail: email@example.com
Objective To 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 HCC, 26 cholangiocarcinoma, 171 HCC adjacent hepatic tissue including cirrhosis, 93 hemangioma adjacent hepatic tissues. 84 carcinomas metastatic to liver. GPC3 (Clone 1G12) protein are detected immunohistochemically in all of cases with positive controls.
Results GPC3 protein is positive in 72.0% HCC (270/357 cases), 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%) followed by grade 2(73.3%), grade 1 (50%) and grade 4 (0%).
Conclusion GPC3 immunohistochemistry is a valuable diagnostic marker for hepatocellular carcinoma with sensitivity 72.0%, and a differential diagnostic marker from tumor adjacent hepatic tissue and carcinomas metastatic to liver with specificity 100%.
[Key Words] Hepatocellular carcinoma; Tissue microarray; GPC3; Immunohistochemistry