甲胎蛋白阳性人肝细胞的定量形态学图像分析  

Morphometric image analysis of human α-fetoprotein positive hepatocytes

作　　者：章宗籍[1] 申丽娟[1] 张华献[1] 黄润[1] 

机构地区：[1]昆明医学院病理学教研室,云南省昆明市650031

出　　处：《世界华人消化杂志》2004年第6期1284-1287,共4页World Chinese Journal of Digestology

基　　金：云南省自然科学基金资助;No.92C051~~

摘　　要：目的:为阐明肝细胞性肝癌癌变前期AFP阳性表达肝细胞的形态特征,以进一步探讨肝癌癌变规律并以此寻求能够早期诊断肝癌的方法. 方法:SP法对正常肝组织,慢性肝炎肝硬化,癌周肝硬化和肝细胞癌共114例进行甲胎蛋白(AFP)的检测,并对AFP 阳性肝细胞及AFP阴性肝细胞进行了核面积、核平均体积、核等效直径、核长轴/短轴比、核形状因子、核异型指数、细胞面积、细胞等效直径、细胞平均体积、细胞长轴/短轴比、核质比等111项参数的形态定量测定和对比分析. 结果:正常肝组织和慢性肝炎肝硬化AFP不表达;癌周肝硬化AFP阳性率为37%(10/27);肝细胞癌AFP阳性率为45% (17/38).对癌周肝硬化AFP阳性和阴性肝细胞形态定量分析,10例AFP阳性组的阳性表达肝细胞与其余17例阴性组的肝细胞在细胞长轴/短轴比、核形状因子和核异型指数3项参数间有显著差异(P<0.05);进一步对AFP阳性组同片阳性肝细胞和阴性肝细胞比较分析,有4例在11项形态参数中存在不同程度的差别,其中可见AFP阳性肝细胞较AFP阴性细胞小,核不同程度增大,核质比例增大, 以及在反映核不规则程度的核长轴/短轴比、核形状因子和核异型指数等参数上有明显变化. 结论:癌周肝硬化不同于不伴肝癌的肝硬化而更具癌前病变性质;在与肝癌发生相关的病变中,AFP的表达早于细胞形态学的改变;随着AFP的表达,部分AFP阳性肝细胞发生的形态学改变己具备癌前病变的性质,其可能是肝绌胞癌变的基础.AIM: To determine the morphometric characteristics of α-fetoprotein (AFP) positive hepatocytes which appeared in precursor lesions, and to explore the mechanism of car-cinogenesis and the early diagnostic method of hepato-cellular carcinoma. METHODS: The expression of AFP was investigated by immunohistochemical SP method in 114 cases of normal liver, chronic hepatitis/cirrhosis, pericancerous cirrhosis and hepatocellular carcinoma (HCC). 11 morphometric parameters of AFP-positive and negative hepatocytes including nuclear area, nuclear volume, nuclear equivalent diameter, nuclear long diameter/short diameter ratio, nuclear form factor, nuclear irregular index, cell area, cell volume, cell equivalent diameter, cell long diameter/short diameter ratio and nucleus-cytoplasm ratio were measured by using an automated image analyser. RESULTS: The expression of AFP was negative in normal liver and chronic hepatitis/cirrhosis, positive 37% (10/27) in pericancerous cirrhosis and 45% (17/38) in HCC. Morphometric study on the positive and negative hepatocytes in pericancerous cirrhosis showed that the difference was statistically significant between the groups of 10 AFP-positive and 17 AFP-negative on the parameters of cell long diameter/short diameter ratio, nuclear form factor and nuclear irregular index. However, the investigation of positive and negative hepatocytes in same AFP-positive case showed that several parameters in positive cells were significantly different from those in negative cells in 4 cases. This AFP- positive cells changed their features as enlarged nuclear and nucleus to cytoplasm ratio, and more irregular nucleus. CONCLUSION: The pericancerous cirrhosis is different essentially from the liver cirrhosis without tumor, and more closely linked with HCC. The AFP expression of hepato-cytes may occur earlier than its morphologic change in hepatocarcinogenesis. These AFP-positive and morphologic changed hepatocytes may be the precursor of HCC.

关 键 词：甲胎蛋白 肝细胞 定量形态学图像 肝硬化 肝组织 

分 类 号：R735.7[医药卫生—肿瘤]