Comparison of 5 Immunohistochemical Markers of Hepatocellular Differentiation for the Diagnosis of Hepatocellular Carcinoma
Comparison of 5 Immunohistochemical Markers of Hepatocellular Differentiation for the Diagnosis of Hepatocellular Carcinoma
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DOI：
10.5858/arpa.2014-0479-oa
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发表时间：
2015-08-01
影响因子：
4.6
通讯作者：
Kakar, Sanjay
中科院分区：
文献类型：
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作者：
Thuy Nguyen;Phillips, Daniel;Kakar, Sanjay
背景：几种免疫组织化学标记物可用于确定肝细胞癌的诊断。对79例肝细胞癌进行肝细胞石蜡抗原1(Hep PAR 1)、多克隆癌胚抗原(CEA)、Glypcan-3、精氨酸酶-1和胆盐输出泵转运蛋白的免疫组织化学染色，共观察93例(高分化13例[14%]，中分化41例[44%]，结果精氨酸酶-1和Hep-PAR-1对高分化肝细胞癌的敏感性最高，而精氨酸酶-1和Glypcan-3对低分化肝细胞癌的敏感性最高。当超过50%的肿瘤染色为阳性时，精氨酸酶-1仍然是所有分化程度最敏感的标记物，而Hep-PAR-1在低分化肝细胞癌中的敏感度降至30%，而Glypcan-3在高分化肝细胞癌中的敏感度为15%。在精氨酸酶-1中加入Hep-PAR-1和/或多克隆CEA并未导致对任何分化的敏感性增加。联合应用精氨酸酶-1和Glypcan-3对低分化肝细胞癌的敏感性为100%。结论-精氨酸酶-1是肝细胞癌所有分化程度中最敏感的标志物。GLYPICAN-3对低分化病例有很高的敏感性，它与精氨酸酶-1结合使用能够识别几乎所有的低分化肝细胞癌病例。虽然胆盐输出泵转运体具有良好的整体敏感性，但当它与精氨酸酶-1与Glypcan-3或Hep PAR 1一起加入时，其在建立肝细胞分化方面的作用有限。
Context.-Several immunohistochemical markers are available to establish the diagnosis of hepatocellular carcinoma. Judicious selection is essential to achieve a reliable diagnosis in limited tissue provided by liver biopsy.Objective.-To compare the efficacy of 5 hepatocellular markers for the diagnosis of hepatocellular carcinoma across various levels of differentiations.Design.-Immunohistochemistry for hepatocyte paraffin antigen 1 (Hep Par 1), polyclonal carcinoembryonic antigen (CEA), glypican-3, arginase-1, and bile salt export pump transporter was performed in 79 hepatocellular carcinomas, yielding 93 observations (13 well-differentiated [14%], 41 moderately differentiated [44%], and 39 poorly differentiated [42%] tumors).Results.-Arginase-1 and Hep Par 1 had the highest sensitivity for well-differentiated hepatocellular carcinoma, whereas arginase-1 and glypican-3 had the highest sensitivity for poorly differentiated hepatocellular carcinoma. When staining of more than 50% of the tumor was considered a positive result, arginase-1 remained the most sensitive marker for all differentiations, whereas sensitivity for Hep Par 1 in poorly differentiated hepatocellular carcinoma dropped to 30% and that of glypican-3 in well-differentiated hepatocellular carcinoma was 15%. The addition of Hep Par 1 and/or polyclonal CEA to arginase-1 did not lead to an increase in sensitivity for any differentiation. The combined use of arginase-1 and glypican-3 yielded 100% sensitivity for poorly differentiated hepatocellular carcinoma.Conclusion.-Arginase-1 was the most sensitive marker in all differentiations of hepatocellular carcinoma. Glypican-3 had high sensitivity for poorly differentiated cases and its combined use with arginase-1 enabled identification of nearly all cases of poorly differentiated hepatocellular carcinoma. Although bile salt export pump transporter has good overall sensitivity, it has a limited role in establishing hepatocellular differentiation when added to a panel of arginase-1 with either glypican-3 or Hep Par 1.