摘要目的 探讨精氨酸酶1 (Arg-1)、磷脂酰肌醇蛋白聚糖-3(GPC3)、Hepatocyte paraffin antigen 1(HepPar-1)及甲胎蛋白在原发性肝细胞癌、肝脏良性病变及肝脏转移癌中的表达情况及在诊断与鉴别诊断中的应用价值.方法 应用免疫组织化学EnVision二步法对3组病例,即85例肝细胞癌、35例肝脏良性病变及19例肝脏转移癌分别进行Arg-1、GPC3、HepPar-1和甲胎蛋白免疫组织化学标记,分析抗体的表达在肝脏肿瘤诊断、鉴别诊断中的应用价值.结果 Arg-1、GPC3、HepPar-1和甲胎蛋白在肝细胞癌、肝脏良性病变及肝脏转移癌中的阳性表达率分别为90.6％(77/85)、100％(35/35)和1/19; 82.4％(70/85)、0(0/35)和1/19;72.9％(62/85)、100％(35/35)和2/19; 47.1％(40/85)、0(0/35)和0(0/19).Arg-1敏感性高于甲胎蛋白及HepPar-1(P值分别为0.000,0.002),GPC3在肝细胞癌的诊断中具有较高的特异性(98.1％).结论 Arg-1是一个敏感的肝细胞标志物,对鉴别肝脏转移癌及转移到其他器官的肝细胞癌有重要作用;GPC3在肝细胞癌的诊断中具有较高的特异性,对肝细胞性肿瘤的良恶性判断有意义,此4种抗体对肝脏肿瘤的诊断和鉴别诊断及预后推测具有应用价值.

abstractsObjective To study the expression of arginase-1 (Arg-1),glypican-3 (GPC3),hepatocyte paraffin antigen 1 (HepPar-1) and alpha-fetoprotein (AFP) in hepatocellular carcinoma (HCC),benign liver lesions (BLL) and metastatic carcinoma (MC),and their applications in diagnosis and differential diagnosis.Methods Immunohistochemical study (EnVision method) for Arg-1,GPC3,HepPar-1 and AFP was carried out in three groups of liver lesions,including 85 cases of HCC,35 cases of BLL and 19 cases of MC.The relationship between expression of Arg-1,GPC3,HepPar-1 and AFP and clinicopathologic features in HCC was also analyzed.Results The positive expression rate of Arg-1 was 90.6％ (79/85) in HCC and 100％ (35/35) in BLL.Arg-1 expression was observed in 1 of the 19 cases of MC studied.The positive expression rate of GPC3 was 82.4％ (70/85) in HCC,5.3％ (1/19) in MC and 0 (0/35) in BLL.The positive expression rate of AFP was 47.1％ (40/85) in HCC and 0 in BLL or MC.The positive expression rate of HepPar-1 was 72.9％ (62/85) in HCC,100％ (35/35) in BLL and 2/19 in MC.Arg-1 has a higher sensitivity in highlighting hepatocellular lesions than AFP and HepPar-1 (P=0.000 versus P=0.002).The specificity of GPC3 expression in HCC was 98.1％.Conclusions Arg-1 is a sensitive hepatocellular marker in delineation of liver lesions.GPC3 is a relatively specific marker in diagnosis of HCC.