脂酰肌醇蛋白3在肝母细胞瘤中的表达特征及诊断意义  

Glypican 3 expression in hepatoblastoma and its diagnostic implication

作　　者：王凤华 文剑明[2] 黄香婷 叶玉清[2] 

机构地区：[1]510623广州市妇女儿童医疗中心病理科 [2]澳门镜湖医院病理科

出　　处：《中华病理学杂志》2013年第12期806-809,共4页Chinese Journal of Pathology

基　　金：澳门科学技术发展基金（068/2009/A）

摘　　要：目的 探讨脂酰肌醇蛋白3（GPC3）在肝母细胞瘤中的表达方式和诊断意义.方法 制作5个含54例肝母细胞瘤（病例收集于2000至201 1年）的组织芯片,其中包括3例肿瘤组织活检标本、33例穿刺活检标本、5例一期手术切除标本、13例介入治疗后二期手术标本.54例肝母细胞瘤的组织学分型,单纯胎儿型22例,混合性胎儿和胚胎型24例,混合性上皮和间叶型8例.另选10例同龄瘤旁肝组织作为对照.全部病例采用免疫组织化学检测GPC3（1G12克隆）蛋白表达,并设阳性对照.结果 22例胎儿型的上皮细胞GPC3均呈阳性反应（100％）;24例混合性胎儿和胚胎型中的胎儿型上皮细胞GPC3阳性,胚胎型上皮细胞为微弱阳性或阴性,而小细胞未分化成分为阴性;8例混合性上皮和间叶型的上皮成分GPC3反应同胎儿型或胚胎型,而间叶成分不表达GPC3.同龄瘤旁肝细胞GPC3为阴性（0/10）.结论 GPC3在肝母细胞瘤的小细胞未分化成分不表达,在胚胎肝成分不表达或微弱表达,在胎儿肝成分明显表达,在出生后肝组织表达消失.GPC3免疫组织化学是婴幼儿肝母细胞瘤良好的诊断标志物.Objective To explore the expression and diagnostic significance of glypican-3 （GPC3） in hepatoblastoma.Methods Five tissue microarray paraffin blocks were constructed to include 54 cases of hepatoblastoma.The tumor tissue samples were obtained from 3 surgical biopsies,33 needle biopsies,5 stage Ⅰ resection tumors,and 13 stage Ⅱ resection tumors after transcatheter arterial chemoembolization.Ten samples of non-neoplastic hepatic tissue adjacent to tumor were used as control.Immunohistochemical staining of GPC3 （clone 1G12） was performed.Among the 54 cases of hepatoblastoma,22 cases were fetal subtype,24 cases were mixed fetal and embryonal subtype and 8 cases were mixed epithelial and mesenchymal type.Results GPC3 was positive in fetal epithelial cells （54/54,100%）,but negative or weakly positive in embryonic epithelial cells in all cases of hepatoblastoma.Undifferentiated small cells and all mesenchymal components were negative for the expression.Non-neoplastic hepatocytes adjacent to tumor were negative for GPC3 expression （0/10）.Conclusions Fetal epithelial components of hepatoblastoma express GPC3 protein detectable by immunohistochemistry.Normal hepatocytes after birth,small cell undifferentiated and embryonic epithelial components of hepatoblastoma do not or weakly express GPC3 protein.Therefore,GPC3 immunohistochemistry offers a valuable aid to the diagnosis of hepatoblastoma in infants and children.

关 键 词：肝肿瘤 磷脂酰肌醇蛋白聚糖类 诊断 鉴别 

分 类 号：R735.7[医药卫生—肿瘤]