| Dongling Zhu,Dong Kuang,Sijuan Zou,Lixing Chen,Yuanli Zhu,Xiaohua Zhu. Immunohistochemical panel of glypican-3 hepatocyte paraffin antigen-1, arginase-1, cytokeratin-19, and human epithelial membrane antigen for the differential diagnosis of liver tumors. Oncol Transl Med, 2019, 5: 153-161. |
| GPC3，Hepar-1，Arg1，EMA及CK19免疫组织化学联合标志物在肝癌鉴别诊断中的作用* |
| Immunohistochemical panel of glypican-3 hepatocyte paraffin antigen-1, arginase-1, cytokeratin-19, and human epithelial membrane antigen for the differential diagnosis of liver tumors |
| Received:April 16, 2019 Revised:August 29, 2019 |
| DOI：10.1007/s10330-019-0351-1 |
| 中文关键词: 肝细胞癌；肝内胆管细胞癌；混合型肝癌；免疫组织化学 |
| 英文关键词: hepatocellular carcinoma (HCC); intrahepatic cholangiocarcinoma (ICC); combined hepatocellular and cholangiocarcinoma (CHC); immunohistochemistry |
| 基金项目:国家自然科学基金(81271600, 81671718 and 81873903)；湖北省自然科学基金 (No. 2016CFB687) ；同济医院临床基金(No. 2015C013) |
| Author Name | Affiliation | E-mail | | Dongling Zhu | Department of Nuclear Medicine and PET, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | 714257103@qq.com | | Dong Kuang | Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Sijuan Zou | Department of Nuclear Medicine and PET, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Lixing Chen | Department of Nuclear Medicine and PET, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Yuanli Zhu | Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Xiaohua Zhu* | Department of Nuclear Medicine and PET, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | evazhu@vip.sina.com |
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| 中文摘要: |
| 目的 免疫组织化学在临床病理诊断中扮演着越来越重要的角色。本研究将探讨磷脂酰肌醇蛋白聚糖-3(Glypican-3，GPC3)，肝细胞石蜡抗原-1(Hepatocyte paraffin antigen-1，Hepar-1)，精氨酸酶-1(Arginase-1，Arg-1)，甲胎蛋白(alpha-fetoprotein，AFP)，人上皮膜抗原(Human epithelial membrane antigen，EMA)及细胞角蛋白19(Cytokeratin-19，CK19)免疫组织化学联合标志物在肝癌鉴别诊断中的作用。
方法 收集235例于2012年1月至2015年5月武汉同济医院病理科进行免疫组织化学的肝细胞癌(hepatocellular carcinoma，HCC，120例)、肝内胆管细胞癌(intrahepatic cholangiocarcinoma，ICC，50例)，混合型肝癌(combined hepatocellular and cholangiocarcinoma，CHC，17例)，肝转移性腺癌 (metastatic adenocarcinoma，20例)与肝良性病变 (benign liver lesions，28例)切片样本,计算并分析联合标志物GPC3/Hepar-1/Arg-1/EMA/CK19诊断HCC，ICC和CHC的敏感性和特异性。
结果 联合标志物GPC3+/CK19-诊断HCC的特异性达到最高值98.3%，敏感性为60%。GPC3-/HepPar-1-/Arg-1-/CK19+/EMA+诊断ICC的特异性达到93.0%，敏感性为76.0%。GPC3+/HepPar-1+/Arg-1+/CK19+/EMA+诊断CHC的特异性达到95.9%，敏感性为52.9%。
结论 免疫组织化学标志物GPC3/HepPar-1/Arg-1/CK19/EMA联合运用能够有效提高肝癌诊断的特异性，从而为临床病理工作明确肝脏病灶性质来源提供帮助。 |
| 英文摘要: |
| Objective Clinical immunohistochemistry plays an increasingly important role in pathologic diagnosis.
We investigated the usefulness of an immunohistochemical panel of glypican-3 (GPC3), hepatocyte
paraffin antigen-1 (HepPar-1), arginase-1 (Arg-1), cytokeratin-19 (CK19), and human epithelial membrane
antigen (EMA) for the differential diagnosis of liver tumors.
Methods Two hundred and thirty-five immunohistochemical sections of hepatocellular carcinoma
(HCC; 120 cases), intrahepatic cholangiocarcinoma (ICC; 50 cases), combined hepatocellular and
cholangiocarcinoma (CHC; 17 cases), metastatic adenocarcinoma (20 cases), and benign liver lesions
(28 cases) were obtained from the Department of Pathology at Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, China. The sensitivity and specificity of the
combined biomarkers GPC3/HepPar-1/Arg-1/CK19/EMA for the differential diagnosis of HCC, ICC, and
CHC were calculated and analyzed retrospectively.
Results The combined biomarkers GPC3+/CK19– had the highest specificity (98.3%) for diagnosing
HCC, with a sensitivity of 60.0%. The specificity of GPC3–/HepPar-1–/Arg-1–/CK19+/EMA+ for diagnosing
ICC was 93.0%, with a sensitivity of 76.0%. The specificity of GPC3+/HepPar-1+/Arg-1+/CK19+/EMA+ for
diagnosing CHC was 95.9%, with a sensitivity of 52.9%.
Conclusion The combined biomarkers GPC3/HepPar-1/Arg-1/CK19/EMA greatly improved the
specificity of liver tumor diagnosis. We believe that clinical pathological work could improve the original
determination of liver nodules. |
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