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目的探讨组织蛋白酶Ｄ和嗜铬颗粒素Ａ在人原发性肝细胞癌（ＨＣＣ）的表达及其意义．方法免疫荧光双标记染色技术结合激光扫描共聚焦显微镜观察ＨＣＣ８５例．结果组织蛋白酶Ｄ在正常肝细胞有弱表达，但在ＨＣＣ组织，组织蛋白酶Ｄ的表达显著增强，而且癌细胞荧光染色强度存在区域性差别，通常临床恶性程度越高、肿瘤分化越差，荧光染色较强的癌细胞越多．ＨＣＣ的组织学分级越高，组织蛋白酶Ｄ的表达越多．８５例ＨＣＣ中有７１例癌细胞呈组织蛋白酶Ｄ强阳性，阳性率８３５％．在组织学分级为３～４级的２８例中，组织蛋白酶Ｄ阳性的占２６例（阳性率９２９％）；组织学分级为２级的５３例中，有４６例阳性（阳性率８６８％）；而组织学分级为１级的４例中，仅有１例阳性（阳性率２５０％）．组织蛋白酶Ｄ阳性细胞的分布，在组织学分级不同的ＨＣＣ中有明显差别（Ｐ＜００１）．我们还发现组织蛋白酶Ｄ的表达与患者年龄无明显关系．有组织蛋白酶Ｄ表达的患者平均年龄为５１２岁±２８岁（３２岁～６８岁），无组织蛋白酶Ｄ表达的患者平均年龄为５１２岁±４５岁（２８岁～７１岁）（Ｐ＞００５）．组织学分级为１级的ＨＣＣＣｇＡ阳性率为７５０％（３／４），２级的阳性率７１?
3. Objective To investigate the expression and significance of cathepsin D and chromogranin A in human primary hepatocellular carcinoma (HCC). Methods Immunofluorescence double labeling staining technique was used to observe 85 cases of HCC with laser scanning confocal microscope. Results Cathepsin D was weakly expressed in normal liver cells, but the expression of cathepsin D was significantly increased in HCC tissues. There was a regional difference in fluorescence staining intensity of cancer cells. The higher the degree of clinical malignancy, the worse the tumor differentiation, and the fluorescence staining. Stronger cancer cells. The higher histological grade of HCC, the more cathepsin D expression. Among the 85 cases of HCC, 71 cases of cancer cells were strongly positive for cathepsin D, with a positive rate of 83.5%. Among the 28 cases with histological grades 3 to 4, cathepsin D was positive in 26 cases (positive rate 92.9%); of the 53 cases in grade 2 histology, 46 cases were positive (positive rate 86. 8%); of the 4 cases with grade 1 histology, only 1 was positive (positive rate 250%). The distribution of cathepsin D positive cells was significantly different in histological graded HCC (P<001). We also found that cathepsin D expression was not significantly related to the age of the patient. The average age of patients with cathepsin D expression was 51 2 years old ± 2 8 years old (32 ～ 68 years old), and the average age of patients without cathepsin D expression was 51 2 years ± 4 5 years old (28 years old ~ 71 years old) (P>005). The positive rate of HCCCgA in histological grade 1 was 75.0% (3/4), and the positive rate of 2 was 71.