AFP在肝细胞肝癌、胆管细胞癌、结节性肝硬化中的表达及鉴别意义

发布时间：2018-03-16 00:33

本文选题：肝细胞肝癌　切入点：肝内胆管细胞癌　出处：《山西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:探讨三种肝癌分别为肝细胞肝癌和肝内胆管细胞癌和结节性肝硬化中GPC3、AFP的表达并且比较GPC3、AFP在肝三种肝癌中表达的差异。方法:通过对总共92例患者的分别比较50例原发性肝细胞肝癌、20例肝内胆管细胞癌、22例结节性肝硬化的细胞,采用免疫组织化学方法对92例患者手术切除标本中细胞进行GPC3、AFP检测,检测GPC3在三种肝癌不同时期和分化的阳性表达情况,比较GPC3、AFP在三种肝癌中表达的差异。结果:肝细胞肝癌的细胞中GPC3特异性表达且具有敏感性,敏感性分别为84.0%、97.7%,与其余两种肝癌中GPC3的表达相比,两者差异有统计学意义(P0.05)。肝细胞肝癌中细胞GPC3蛋白的表达与患者各个方面的差异无统计学意义(P0.05)。在三种分期的肝细胞肝癌中GPC3的阳性率分别为82.4%、84.9%,均明显高于肝细胞肝癌中AFP蛋白的表达,两者相比较差异具有统计学意义(P0.05)。肝细胞肝癌中的GPC3和AFP两者联合,就能检测并且诊断极早期+早期、中期+进展期肝细胞肝癌,检测和诊断的敏感性提高为88.2%、87.8%。三种不同程度分化的肝细胞肝癌中的GPC3蛋白的阳性率分别为75.0%、85.0%、81.8%,均明显高于肝细胞肝癌中AFP这种蛋白的表达,差异具有统计学意义(P0.05)。三种分化程度的肝细胞肝癌中GPC3和AFP两者联合检测可将诊断阳性率的敏感性提高为75.0%、90.0%、90.9%。GPC3肝内胆管细胞癌各个分期相比,各种分期的肝内胆管细胞癌中的GPC3阳性率分别为0%、6.25%,与肝内胆管细胞癌中AFP蛋白的表达相比,无明显统计学差异(P0.05)。不同分化程度的肝细胞肝癌中GPC3的阳性率分别为25.0%、0%、0%,与肝内胆管细胞癌中AFP蛋白的表达相比无明显统计学差异(P0.05)。结论:肝细胞肝癌中细胞中GPC3高表达并且可能参与肝细胞肝癌的产生和进展。GPC3高表达于肝细胞肝癌组织中,对早期肝细胞肝癌诊断的重要提示作用,对于区分良性及恶性早期占位性病变重要提示作用。
[Abstract]:Objective: to investigate the expression of GPC3P AFP in hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (HCC) and nodular cirrhosis (LC) and to compare the difference of GPC3 AFP expression in hepatocarcinoma. Methods: a total of 92 patients were enrolled in this study. The cells of 20 cases of intrahepatic cholangiocarcinoma and 22 cases of nodular liver cirrhosis were compared in 50 cases of primary hepatocellular carcinoma (HCC) and 20 cases of intrahepatic cholangiocarcinoma. Immunohistochemical method was used to detect the expression of GPC3 in the cells of 92 patients undergoing surgical resection, and the positive expression of GPC3AFP was detected at different stages and differentiation of three kinds of liver cancer. Results: the expression of GPC3 in HCC cells was specific and sensitive, and the sensitivity was 84.0 and 97.7, respectively, compared with the expression of GPC3 in the other two types of HCC. The difference was statistically significant (P 0.05). There was no significant difference between the expression of GPC3 protein in hepatocellular carcinoma and all aspects of the patients. The positive rates of GPC3 in the three stages of HCC were 82.4% and 84.9%, respectively, which were significantly higher than those in the fine liver tissue. Expression of AFP protein in hepatocellular carcinoma, The combination of GPC3 and AFP in hepatocellular carcinoma can detect and diagnose very early and middle stage advanced hepatocellular carcinoma. The sensitivity of detection and diagnosis was increased to 87.8%. The positive rates of GPC3 protein in the three kinds of differentiated hepatocellular carcinoma were 75.0% and 85.0%, respectively, which were significantly higher than the expression of AFP protein in hepatocellular carcinoma (HCC). The difference was statistically significant (P 0.05). The combined detection of GPC3 and AFP in three kinds of hepatocellular carcinoma with different degrees of differentiation could increase the sensitivity of the positive rate to 75.0% and 90.9%, compared with each stage of intrahepatic cholangiocarcinoma. The positive rates of GPC3 in various stages of intrahepatic cholangiocarcinoma were 0 and 6.25, respectively, compared with the expression of AFP protein in intrahepatic cholangiocarcinoma. The positive rates of GPC3 in hepatocellular carcinoma with different differentiation degrees were 25.0 and 25.0, respectively. There was no significant difference between the expression of AFP protein and that of intrahepatic cholangiocarcinoma. Conclusion: the expression of GPC3 in hepatocellular carcinoma is not significantly different from that in intrahepatic cholangiocarcinoma. Conclusion: there is no significant difference in the expression of AFP protein between HCC and HCC. Conclusion: there is no significant difference in the expression of AFP protein between HCC and HCC. High expression and may be involved in the production and progression of hepatocellular carcinoma. GPC3 is highly expressed in hepatocellular carcinoma. It is important to diagnose early hepatocellular carcinoma and to distinguish benign and malignant early occupying lesions.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.7

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