精氨酸酶-1在原发性肝癌及肝转移癌鉴别中的作用

doi:10.3969/j.issn.1004-616x.2014.02.007

癌变·畸变·突变

精氨酸酶-1在原发性肝癌及肝转移癌鉴别中的作用

王斌生

兰州大学第一医院普外科，甘肃兰州 730000

收稿日期:2013-06-14 修回日期:2013-10-13 出版日期:2014-03-30 发布日期:2014-03-30
通讯作者: 王斌生(1981- )，男，甘肃省泾川县人，硕士，主治医师，研究方向：普通外科。E-mail： bswang2006@126.com
作者简介:王斌生(1981- )，男，甘肃省泾川县人，硕士，主治医师，研究方向：普通外科。E-mail： bswang2006@126.com

Effects of arginase-1 in identifying primary hepatocellular carcinoma and hepatic metastasis

WANG Bin-sheng

General Surgery Department of the First Hospital of Lanzhou University，Lanzhou 730000，Gansu，China

Received:2013-06-14 Revised:2013-10-13 Online:2014-03-30 Published:2014-03-30
Contact: 王斌生(1981- )，男，甘肃省泾川县人，硕士，主治医师，研究方向：普通外科。E-mail： bswang2006@126.com
About author:王斌生(1981- )，男，甘肃省泾川县人，硕士，主治医师，研究方向：普通外科。E-mail： bswang2006@126.com

摘要/Abstract

摘要：

目的：探讨精氨酸酶-1(Arg-1)在原发性肝癌(PHC)和肝转移癌(HM)鉴别中的意义。方法：123例肝癌患者行超声引导下细针穿刺活检，标本制作成细胞块进行免疫组化染色，观察Arg-1表达情况。所有患者行手术切除后进行组织病理学诊断，结合细胞学、血清肿瘤标记物、临床及影像学随访结果进行最终判定。计算采用Arg-1鉴别PHC和HM的敏感度和特异性。结果：123例患者中PHC 78例，HM 45例。在PHC患者中，Arg-1呈高表达(83.3%)且以强染色为主(60.3%)，高、中度分化肝细胞癌患者中阳性表达率(92.9%)高于低分化患者(76.9%)，在胆管细胞型肝癌患者中不表达，在混合型肝癌患者中阳性表达率为75%；在HM患者中，Arg-1阳性表达率较低(8.9%)，存在于结直肠癌、胰腺癌、乳腺癌肝转移患者中且均为弱染色，其他原发部位肝转移患者未见Arg-1阳性表达。Arg-1用于PHC和HM鉴别的敏感度为83.3%，特异性为91.1%。结论：细针穿刺活检标本行Arg-1免疫组化染色用于PHC和HM鉴别的敏感度和特异性均较高，值得进一步推广。

关键词: 精氨酸酶-1, 原发性肝癌, 肝转移癌, 细针穿刺活检

Abstract:

OBJECTIVE: To study the significance of arginase-1 (Arg-1) in identifying primary hepatic carcinoma (PHC) and hepatic metastasis (HM). METHODS：Fine-needle aspiration biopsies (FNABs) were performed in 123 patients，cell block were made and immunohistochemical staining were applied. The expression of arginase-1 was measured. All patients received surgical resection and histopathologic diagnosis were obtained. Cytology，serum tumor markers，clinical and radiographic follow-up results were used for a final decision. The sensitivity and specificity of Arg-1 in identifying PHC and HM were calculated. RESULTS：123 patients diagnosed to have PHC (78 cases) or HM (45 cases). High expression was present in PHC group (83.3%) and stained strongly (60.3%). Positive expression rate of highly and moderately differentiated patients (92.9%) were higher than lowly differentiated patients (76.9%)，with no expression in cholangiocarcinoma patients. In the hybrid liver cancer patients the positive expression rate was 75%. In patients with HM，Arg-1 positive expression rate was low (8.9%) with weak staining，and were found in HM from colorectal cancer，pancreatic cancer. HM from other primary sites showed no Arg-1 positive expression. The sensitivity and specificity of Arg-1 in identifying PHC and HM were 83.3% and 91.1%，respectively. CONCLUSION： Arginase-1 may be a more sensitive marker of hepatocellular carcinoma (HCC) and hepatic metastasis. FNABs with Arg-1 immunohistochemical staining was sensitive and specific in identifying PHC and HM and warrant further promotion.

Key words: arginase-1, primary hepatic carcinoma, hepatic metastasis, fine-needle aspiration biopsy

王斌生. 精氨酸酶-1在原发性肝癌及肝转移癌鉴别中的作用[J]. 癌变·畸变·突变, doi: 10.3969/j.issn.1004-616x.2014.02.007.

WANG Bin-sheng. Effects of arginase-1 in identifying primary hepatocellular carcinoma and hepatic metastasis[J]. Carcinogenesis, Teratogenesis & Mutagenesis, doi: 10.3969/j.issn.1004-616x.2014.02.007.

参考文献

[1] 曹文俊，Bill Sun，连兆瑞，等. 精氨酸酶I在HCV转染肝癌细胞增殖中的作用[J]. 诊断理论与实践，2007，6(4)：319-322.

[2] 王鹏，刘鲁明，孟志强，等. 2 528例原发性肝癌细针穿刺细胞学检查及其并发症[J]. 中华肝脏病杂志，2007， 15(10)： 758-762.

[3] 陈冰，梁凤泉，马青松，等. B超引导细针穿刺细胞块对肝癌的诊断价值[J]. 中华肿瘤防治杂志，2006， 13(24)： 1890-1892.

[4] Fujiwara M，Kwok S，Yano H，et al. Arginase-1 is a more sensitive marker of hepatic differentiation than HepPar-1 and glypican-3 in fine-needleaspiration biopsies [J]. Cancer Cytopathol， 2012，120 (4)：230-237.

[5] 中华抗癌协会肝癌专业委员会. 原发性肝癌诊断标准[J]. 中华肝脏病杂志，2000，8(3)：135.

[6] 徐建业，林   丁，李伟道，等. 甲胎蛋白诊断原发性肝癌准确性的系统评价[J]. 中国循证医学杂志，2009， 9(5)： 525-530.

[7] 吕晓娴，张瑞丽，刘   冰. 血清中癌胚抗原检测对鉴别诊断肝癌的临床价值[J]. 中国误诊学杂志，2007， 7(7)： 1491-1491.

[8] 郑航，左强，张军一，等. 若干肿瘤标志物对原发性肝癌诊断的临床评价[J]. 陕西医学杂志，2006， 35(2)： 192-195.

[9] 潘   源，梁   寒，钱碧云，等. AFU、AFP及CEA对原发性肝癌的诊断意义[J]. 中国肿瘤临床，2002，29(6)：444-445.

[10] 张秀梅，严   昆，陈敏华，等. 原发性肝癌及肝转移癌局部治疗后超声造影表现类型及其诊断价值[J]. 中华医学超声杂志：电子版，2009，6(1)：14-18.

[11] 王秀云，李风华. 原发性肝癌和肝转移癌的彩色超声鉴别诊断[J]. 实用肿瘤学杂志，2000，14(1)：44-46.

[12] 梁莉，梁艳，张宏，等. 实时超声造影在肝转移癌中的诊断与应用研究[J]. 武警医学，2008，19(1)：65-67.

[13] 曲波，李宝杰，吕志武，等. 细针肝穿刺标本检测端粒酶诊断肝癌的意义[J]. 世界华人消化杂志，2001， 9(5)： 538-540.

[14] 陶   璇，王斌，黄爱民，等. 精氨酸酶1在肝细胞癌中的表达及其临床病理意义[J]. 中华消化杂志，2012， 32(2)： 113-117.

[15] 岳瑛，岳冀，邓红燕，等. 重组长效人精氨酸酶抑制肿瘤细胞生长的研究[J]. 武警医学，2010，21(3)：225-227.

[16] McKnight R， Nassar A，Cohen C，et al. Arginase-1：a novel immunohistochemical marker of hepatocellular differentiation in fine needle aspirationcytology [J]. Cancer Cytopathol， 2012， 120(4)：223-229.

[17] Radwan NA，Ahmed NS. The diagnostic value of arginase-1 immunostaining in differentiating hepatocellular carcinoma from metastatic carcinoma and cholangio carcinoma as compared to HepPar-1 [J]. Diagn Pathol，2012，7(1)：149.

[18] Yan BC，Gong C，Song J，et al. Arginase-1：a new immunohistochemical marker of hepatocytes and hepatocellular neoplasms[J]. Am J Surg Pathol， 2010，34(8)：1147-1154.

精氨酸酶-1在原发性肝癌及肝转移癌鉴别中的作用

Effects of arginase-1 in identifying primary hepatocellular carcinoma and hepatic metastasis

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 0

编辑推荐

Metrics

本文评价