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目的:探讨磷脂酰肌醇蛋白聚糖3(GPC3)在肝细胞癌(HCC)等不同肝病组织中的表达情况及其对肝癌早期诊断的意义.方法:采用免疫组织化学方法检测126例肝穿刺活检标本(包括13例极早期HCC、44例早期HCC、16例不典型增生、29例肝硬化和24例肝炎)及57例中晚期HCC手术标本中GPC3和甲胎蛋白(AFP)的表达,28例正常肝组织作对照.结果:GPC3在HCC与其他组织中的表达差异具有统计学意义(P<0.01).GPC3和AFP对HCC诊断的敏感性分别为80.7%和37.7%,特异性分别为99.4%和93.6%.在极早期和早期肝癌中,GPC3的阳性表达率,显著高于AFP(92.3%vs38.5%;72.7%vs34.1%,均P<0.05).GPC3在极早期和早期肝癌中的表达均高于高级别不典型增生组(P<0.01).在肝硬化、肝炎、正常肝组织中均未见GPC3和AFP蛋白表达.GPC3在小肝癌中的阳性率为78.6%,联合AFP可将诊断敏感性提高为85.7%.在血清AFP阴性的小肝癌中GPC3的阳性率高达70%.GPC3阳性表达患者肝癌根治术后1年、2年、3年的复发率明显高于GPC3阴性患者(P<0.05).结论:GPC3在极早期和早期HCC中具有良好的敏感性和特异性,有望成为新的肝癌早期诊断标志物,肝穿刺活检行GPC3染色是一个有效的肝癌早期鉴别诊断的辅助工具,同时也有助于预测HCC患者的预后.
Objective: To investigate the expression of glypican 3 (GPC3) in different liver tissues such as hepatocellular carcinoma (HCC) and its significance in early diagnosis of hepatocellular carcinoma.Methods: Immunohistochemistry was used to detect 126 cases of liver puncture Biopsy specimens (including 13 cases of very early stage HCC, 44 cases of early stage HCC, 16 cases of atypical hyperplasia, 29 cases of cirrhosis and 24 cases of hepatitis) and 57 cases of advanced HCC surgical specimens of GPC3 and AFP expression, 28 cases of normal liver tissue as control.Results: There was significant difference in the expression of GPC3 between HCC and other tissues (P <0.01) .The sensitivity of GPC3 and AFP to diagnosis of HCC were 80.7% and 37.7% Were 99.4% and 93.6%, respectively.The expression of GPC3 in extremely early and early liver cancer was significantly higher than that in AFP (92.3% vs38.5%, 72.7% vs34.1%, all P <0.05) And the expression of GPC3 and AFP in cirrhosis, hepatitis and normal liver tissues were all higher than those in the high-grade atypical hyperplasia group (P <0.01) .The positive rate of GPC3 in small hepatocellular carcinoma was 78.6 %, The combined AFP can increase the diagnostic sensitivity to 85.7% .The positive rate of GPC3 in serum AFP-negative small hepatocellular carcinoma is as high as 70% .GPC3-positive The recurrence rates at 1 year, 2 years and 3 years after radical resection of hepatocellular carcinoma were significantly higher than those with negative GPC3 (P0.05) .Conclusion: GPC3 has good sensitivity and specificity in very early and early stage HCC, and it is expected to become The new diagnostic marker of liver cancer, liver biopsy line GPC3 staining is an effective tool for early diagnosis of liver cancer, but also help predict the prognosis of patients with HCC.