Ki-67、Arginase-1、HepPar-1和Glypican-3在原发性肝癌诊断及鉴别诊断中的意义  

Clinical investigation of diagnosis and differential diagnosis of Ki-67, arginase-1, HepPar-1 and glypican-3 in primary hepatocellular carcinoma

作　　者：张贵慧[1] 杨晓庆[1] 成玉霞[1] 孙青[1] 

机构地区：[1]山东省千佛山医院病理科,济南250014

出　　处：《中国医师杂志》2016年第7期1008-1012,共5页Journal of Chinese Physician

摘　　要：目的探讨Ki-67、Arg-1、HepPar-1和磷脂酰肌醇蛋白-3（Glypican-3）在肝细胞性肝癌中的诊断和鉴别诊断价值。方法 采用免疫组化法对118例肝细胞性肝癌组织标本、100例肝脏非恶性肿瘤组织及263例其他非肝来源的恶性肿瘤组织进行Ki-67、Arg-1、HepPar-1和Glypican-3的表达检测，对不同抗体及其组合的敏感度和特异度进行比较分析。结果 肝癌组织中Ki-67阳性表达率显著高于肝脏非恶性肿瘤组织，差异有统计学意义（P〈0.01）；抗体Arg-1＋HepPar-1＋Glypican-3是诊断肝脏转移性肿瘤的敏感组合，而Ki-67＋Glypican-3＋Arg-1的组合对于肝内良恶性病变的鉴别意义较大。结论 Ki-67是反映肿瘤分化程度、鉴别肝内良恶性病变的敏感指标；在原发性肝癌的诊断和鉴别诊断中，应用不同的免疫组化抗体诊断谱，可以提高诊断的准确性、可靠性和经济性。Objective To explore the diagnostic and differential diagnostic value of Ki-67, Arg-1, HepPar-1 and Glypican-3 in primary hepatocellular carcinoma and benign hepatocellular lesions. Methods A total of 118 cases of primary hepatocellular carcinomas, 100 cases of benign hepatocellular lesions and 263 cases malignant carcinomas originated from other organs were adopted in this study. Immunohistochemistry of Ki-67, Arg-1, HepPar-1 and Gly-3 were performed and evaluated in all specimens. Results The expressions of Ki-67 were concordant with the differentiation of hepatocellular carcinomas and the difference between primary hepatocellular carcinomas and benign hepatocellular lesions were statistically significant （ P 〈0. 01 ）. The combination of Arg-1 ＋ HepPar-1 ＋ Glypican-3 had the most sensitivity and specificity in differential diagnosis between primary hepatocellular and metastatic malignant cancers, while the combination of Ki-67 ＋ Glypican-3 ＋ Arg-1 showed the better diagnostic value in primary hepatocellular carcinomas and benign lesions. Conclusions The application of different immunohistochemical antibody spectra in primary liver cancers could efficiently improve diagnostic accuracy and reliability.

关 键 词：肝肿瘤/代谢/诊断 Ki-67抗原/代谢 精氨酸酶/代谢 磷脂酰肌醇蛋白聚糖类/代谢 抗原/代谢 诊断 鉴别 

分 类 号：R735.7[医药卫生—肿瘤]