混合型肝癌的免疫组织化学分析  

An immunohistochemical study of mixed hepatocarcinoma

作　　者：孙丽萍[1] 周燕[1] 曹敏[1] 陈培辉[1] 

机构地区：[1]浙江大学医学院第二医院病理科,杭州310009

出　　处：《中华消化杂志》2002年第11期671-673,共3页Chinese Journal of Digestion

摘　　要：目的　肝细胞癌、胆管细胞癌以及混合型肝癌三者的病理鉴别诊断有时颇为困难。因此 ,分析这些肿瘤的免疫组化标记特点 ,提供有用的诊断指标。方法　对 1 5例混合型肝癌进行免疫组化S P法观察。结果　 1 5例混合型肝癌占同期原发性肝癌的 3 .39%。组织学特点同时表现为肝细胞癌和胆管细胞癌 ,其中有 1例为罕见的碰撞瘤。免疫组化标记 ,AFP为 1 0 / 1 5例阳性 ,均表达在肝细胞癌的部位中 ,而胆管细胞癌均为阴性。细胞角蛋白 8(CK8)在肝细胞癌成分全阳性 ,而在胆管细胞癌区域有1 3例为阳性 ,2例阴性 ,CK1 9在胆管细胞癌成分全阳性 ,而在肝细胞癌区域也有 1 3例阳性 ,其余为阴性。Bcl 2表达阳性率为 66 .7% (1 0 / 1 5)。大部分表达在胆管细胞癌成分 ,也有 5例在肝细胞癌成分表达阳性。AB/PAS黏液染色在胆管细胞癌的成分均为阳性或弱阳性。结论　诊断混合型肝癌主要依据显微镜下的病理特征 。Objective Pathologically, sometimes it is rather difficult to make differential diagnosis among hepatocellular, cholangiocellular and mixed type of hepatic tumors. The aim of this study was to analyze the immunohistochemical features of mixed type of hepatocarcinoma and to propose some useful diagnostic criteria. Methods Fifteen cases of the hepatic tumor were examined by routine histological and immunohistochemical methods with S P technique. Results The mixed type of hepatic tumor accounted for 3.39% of all cases of primary hepatocarcinoma in the same period. Histologically, all the mixed type of hepatic tumors revealed some characteristics of hepatocellular and cholangiocellular carcinomas, one of them was collision tumor. Immunohistochemically, 10 cases of the tumor were positive for α fetal protein(AFP) in the hepatocellular carcinoma area, while all 15 tumors were negative for AFP in all cholangiocellular carcinoma areas. Cytokeratin(CK8) was positive in the hepatocellular carcinoma areas of all mixed tumor, whereas positive in cholangiocellular carcinoma areas of 13 cases; CK19 was positive in cholangiocellular carcinoma areas of all the tumors, while positive in hepatocellular carcinoma areas of 13 cases. Bcl 2 gene product was positive in 66.7% of this tumor, in which it was mainly expressed in cholangiocellular tumor area and in hepatocellular areas of five cases. AB/PAS stain for mucin was positive in cholangiocellular tumor regions of all the tumors. Conclusions Diagnosis of mixed hepatocarcinoma should be made mainly based on combined analysis of the data from pathological features, immunohistochemical phenotypes and histochemical stain for mucinous material.

关 键 词：混合型肝癌 免疫组织化学 诊断 

分 类 号：R735.7[医药卫生—肿瘤]