Carcinosarcoma of the liver producing granulocyte-colony stimulating factor
Carcinosarcoma of the liver producing granulocyte-colony stimulating factor
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DOI：
10.1111/j.1440-1827.2006.01979.x
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发表时间：
2006-07-01
影响因子：
2.2
通讯作者：
Seki, Kunihiko
中科院分区：
文献类型：
--
作者：
Aita, Kumi;Seki, Kunihiko
本文报告1例尸检发现的肝癌肉瘤产生粒细胞集落刺激因子（G-CSF）。患者为一名74岁的日本男性，表现为多发性肝脏肿块。他的血清G-CSF升高至286 pg/mL，观察到19 - 100/μ L的显著白细胞增多。患者的临床病程迅速恶化，并在入院后57天死亡。尸检发现肝癌肉瘤组成的肝细胞癌（HCC）和肉瘤的元素与α-平滑肌肌动蛋白和结蛋白免疫反应。免疫组化结果显示G-CSF在HCC细胞胞浆中呈阳性表达，而梭形细胞中未见阳性表达。G-CSF的产生也通过酶联免疫吸附试验证实，使用冷冻的肿瘤组织在尸检。与文献中大多数产生G-CSF的肿瘤相似，本例仅上皮细胞呈G-CSF免疫阳性。虽然癌细胞瘤的单克隆起源已被普遍提出，从一个单一的克隆异源分化可能会导致G-CSF的生产只在上皮元素在这种情况下。这表明，G-CSF与上皮细胞的高度转化，以及传统的肝癌产生G-CSF的现象的报告。
An autopsy case of carcinosarcoma of the liver producing granulocyte-colony stimulating factor (G-CSF) is reported. The patient, a 74-year-old Japanese man, presented with multiple liver masses. His serum G-CSF was elevated to 286 pg/mL and a marked leukocytosis of 19 100/mu L was observed. The patient had a rapidly aggravated clinical course and died 57 days after admission. Autopsy revealed a liver carcinosarcoma composed both of hepatocellular carcinoma (HCC) and sarcomatous elements immunoreactive with alpha-smooth muscle actin and desmin. Immunohistochemistry revealed positive staining of G-CSF in the cytoplasm of HCC, whereas none of the spindle cells was positively stained. Production of G-CSF was also confirmed by enzyme-linked immunosorbent assay, using the frozen tumor tissue taken at the autopsy. Similar to the majority of G-CSF-producing tumors in the literature, only the epithelial elements of the present case were immunopositive for G-CSF. Although a monoclonal origin of carcinosarcomas has generally been proposed, heterologous differentiation from a single clone might lead to the production of G-CSF only in the epithelial element in the present case. It is suggested that G-CSF was associated with the high-grade transformation of the epithelial elements, as well as the reported phenomenon of conventional HCC producing G-CSF.