The application of markers (HSP70 GPC3 and GS) in liver biopsies is useful for detection of hepatocellular carcinoma
The application of markers (HSP70 GPC3 and GS) in liver biopsies is useful for detection of hepatocellular carcinoma
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DOI：
10.1016/j.jhep.2008.11.014
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发表时间：
2009-04-01
影响因子：
25.7
通讯作者：
Roncalli, Massimo
中科院分区：
文献类型：
--
作者：
Di Tommaso, Luca;Destro, Annarita;Roncalli, Massimo
背景/目的：肝活检对肝细胞癌的诊断在很大程度上局限于小的肝细胞病变，这些病变在形态上往往具有挑战性，需要仔细区分发育不良结节(高级别)和分化良好的肝癌。方法：我们研究了一组标记物(HSP70G、PC3和GS)在一系列肝活检中的诊断准确性，其中大再生结节(n=13)、低级别发育不良结节(n=21)、高度发育不良结节(n=50)、高分化(VWD)(n=17)、高分化(WD-G1)(n=40)和G2-3型(n=35)。结果：几乎所有大再生和低度不典型增生结节均不染色，而高度不典型增生结节有1个标志物(22%)，无2个或3个标志物。联合检测肝癌的准确率为60.8%(3个标志物)和78.4%(2个标志物)，特异度为100%。以VWD+WD-G1为标准，准确率分别为57%(3个标记物)和72.9%(2个标记物)，特异度为100%。两个免疫反应阳性的标志物(满分3分)被推荐为肝细胞癌最有价值的诊断组合。在其他人体模型中的表达谱研究表明，使用额外的标记可以提高面板的诊断准确性。(C)2009年欧洲肝脏研究协会。爱思唯尔出版，版权所有。
Background/Aims: Liver biopsy for hepatocellular carcinoma (HCC) detection is largely restricted to small hepatocellular lesions, which are often morphologically challenging, requiring careful distinction between dysplastic nodules (high-grade) and well-differentiated HCC.Methods: We investigated the diagnostic accuracy of a panel of markers (HSP70 G PC3 and GS), previously tested in resection specimens, in a series of liver biopsies of large regenerative nodules (n = 13), low-grade dysplastic nodules (n = 21), high-grade dysplastic nodules (n = 50), very well-differentiated (VWD) (n = 17), well-differentiated (WD-G1) (n = 40) and G2-3 (n = 35) HCC.Results: Almost all cases of large regenerative and low-grade dysplastic nodules did not stain while high-grade dysplastic nodules showed 1 marker (22%) but never 2 or 3. For HCC detection the overall accuracy of marker combination was 60.8% (3 markers) and 78.4% (2 markers) with 100% specificity. When restricted to VWD + WD-G1 HCC the accuracy was 57% (3 markers) and 72.9% (2 markers) with 100% specificity.Conclusions: This panel proved useful to detect well-differentiated HCC in biopsy. Two immunoreactive markers (out of 3) are recommended as the most valuable diagnostic combination for HCC detection. The diagnostic accuracy of the panel could be improved using additional markers, as suggested by studies of expression profiling in other human models. (c) 2009 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.