原发性肝细胞癌及癌旁组织中CK7和CK19的表达及意义
摘要
目的：探讨原发性肝细胞癌(Primary Hepatocellular Carcinoma，HCC)及癌旁组织中细胞角蛋白CK7、CKl9和Ki67表达及意义。
方法：应用免疫组化二步法检测30例HCC及癌旁组织中的CK7、CK19和Ki67的表达，分析三者与临床病理的关系。
结果：
1．HCC和癌旁组织中CK7的阳性表达率为36.67％和43.33％：CK19的阳性表达率为53.33％和50.00％：10例单纯肝硬化中CK7、CK19阳性表达率为0％，5例正常肝组织中未见表达。
2．Ki-67的阳性表达率在HCC为56.67％、癌旁肝硬化组织为30.00％、单纯肝硬化为10％。HCC中的阳性表达率分别高于癌旁肝硬化组织和单纯肝硬化组织(均P＜0.05)：癌旁肝硬化组织中Ki-67阳性表达高于单纯肝硬化组织(P＜0.05)。
3．HCC临床分级中，细胞增殖核抗原Ki-67阳性表达均有显著差异(P＜0.05)：HCC大体分型中，结节型肝癌与巨块型比较，CK7、CK19和Ki-67均有显著差异(P＜0.05)。
结论：
1．HCC及癌旁组织中胆管型细胞角蛋白CK7和CK19的高表达，提示部分肿瘤细胞可能来自具有多项分化潜能的肝干细胞。
2．HCC的TNM分类中Ki-67表达有显著性差异，表明Ki-67与HCC的分化程度密切相关；检测Ki-67有助于判断HCC的分化程度和预后。
3．结节型HCC与巨块型比较，CK7、CK19和Ki-67均有显著性差异，呈正相关，提示结节型HCC中CK7和CK19的阳性表达与癌细胞的增殖密切相关。
Objective: To investigate the expression and significance of Cytokeratin 7 and Cytokeratin 19 in liver tissue of primary hepatocellular carcinoma (HCC).
Methods: The expression of Cytokeratin 7 (CK7) , Cytokeratin 19 (CK 9) and Ki-67 antigen was detected by immunohistochemistry in 30 cases of HCC with cirrhosis, 10 cases of cirrhosis and 5 cases of normal liver tissue. The relationships between the expression of CK 7, CK 19, Ki-67 and clinicopathological in HCC was also analyzed.
Results:
1.The positive rates of CK7 and CK19 was 36.67% and 53.33% in30 cases of HCC, 43.33% and 50.00% in 30 cases of cirrhosis with HCC, all 0% in 10 cases of HCC-free cirrhosis. There were no expression in normal liver tissue.
2.The positive ratio of Ki-67 antigen was 56.67%, 30.00% and 10.00% in HCC, cirrhosis with HCC and cirrhosis, respectively, there were significantly differences (P＜0.05)
3.The positive rate of CK7, CK19 and Ki-67 in nodular type HCC was significantly higher than that in massive type HCC (p＜0.05). 3. The positive ratio of Ki-67 HCC were significantly differences (all P＜0.05 ) in different TNM type.
Conclusion:
1.High expression of bile duct-type CK7 and CK19 is presented in HCC, suggesting that tumor cells may partially originate from oval cell through abnormal development.
2.The expression of Ki-67 antigen has significantly differences in different TNM type of HCC, suggesting that there are closed relationship between the expression of Ki-67 antigen and degree of HCC differentiation. The determine of Ki67 was useful to estimate the degree of HCC differentiation and prognosis.
3.The expression of CK7, CK19 and Ki-67 has significantly differences between the nodular and massive types in HCC, it suggested that there has closely relationship between the expression of CK7,CK19 and proliferation of HCC cell in nodular type of HCC.
方法：应用免疫组化二步法检测30例HCC及癌旁组织中的CK7、CK19和Ki67的表达，分析三者与临床病理的关系。
结果：
1．HCC和癌旁组织中CK7的阳性表达率为36.67％和43.33％：CK19的阳性表达率为53.33％和50.00％：10例单纯肝硬化中CK7、CK19阳性表达率为0％，5例正常肝组织中未见表达。
2．Ki-67的阳性表达率在HCC为56.67％、癌旁肝硬化组织为30.00％、单纯肝硬化为10％。HCC中的阳性表达率分别高于癌旁肝硬化组织和单纯肝硬化组织(均P＜0.05)：癌旁肝硬化组织中Ki-67阳性表达高于单纯肝硬化组织(P＜0.05)。
3．HCC临床分级中，细胞增殖核抗原Ki-67阳性表达均有显著差异(P＜0.05)：HCC大体分型中，结节型肝癌与巨块型比较，CK7、CK19和Ki-67均有显著差异(P＜0.05)。
结论：
1．HCC及癌旁组织中胆管型细胞角蛋白CK7和CK19的高表达，提示部分肿瘤细胞可能来自具有多项分化潜能的肝干细胞。
2．HCC的TNM分类中Ki-67表达有显著性差异，表明Ki-67与HCC的分化程度密切相关；检测Ki-67有助于判断HCC的分化程度和预后。
3．结节型HCC与巨块型比较，CK7、CK19和Ki-67均有显著性差异，呈正相关，提示结节型HCC中CK7和CK19的阳性表达与癌细胞的增殖密切相关。
Objective: To investigate the expression and significance of Cytokeratin 7 and Cytokeratin 19 in liver tissue of primary hepatocellular carcinoma (HCC).
Methods: The expression of Cytokeratin 7 (CK7) , Cytokeratin 19 (CK 9) and Ki-67 antigen was detected by immunohistochemistry in 30 cases of HCC with cirrhosis, 10 cases of cirrhosis and 5 cases of normal liver tissue. The relationships between the expression of CK 7, CK 19, Ki-67 and clinicopathological in HCC was also analyzed.
Results:
1.The positive rates of CK7 and CK19 was 36.67% and 53.33% in30 cases of HCC, 43.33% and 50.00% in 30 cases of cirrhosis with HCC, all 0% in 10 cases of HCC-free cirrhosis. There were no expression in normal liver tissue.
2.The positive ratio of Ki-67 antigen was 56.67%, 30.00% and 10.00% in HCC, cirrhosis with HCC and cirrhosis, respectively, there were significantly differences (P＜0.05)
3.The positive rate of CK7, CK19 and Ki-67 in nodular type HCC was significantly higher than that in massive type HCC (p＜0.05). 3. The positive ratio of Ki-67 HCC were significantly differences (all P＜0.05 ) in different TNM type.
Conclusion:
1.High expression of bile duct-type CK7 and CK19 is presented in HCC, suggesting that tumor cells may partially originate from oval cell through abnormal development.
2.The expression of Ki-67 antigen has significantly differences in different TNM type of HCC, suggesting that there are closed relationship between the expression of Ki-67 antigen and degree of HCC differentiation. The determine of Ki67 was useful to estimate the degree of HCC differentiation and prognosis.
3.The expression of CK7, CK19 and Ki-67 has significantly differences between the nodular and massive types in HCC, it suggested that there has closely relationship between the expression of CK7,CK19 and proliferation of HCC cell in nodular type of HCC.
引文
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[5] Libbrecht L, De Vos R, Cassiman D, et al. Hepatic progenitor cells in he patocellular adenomas. Am J Surg Pathol 2001; 25:1388-1396
[6] 朱言亮，陈孝平，等．大鼠实验性肝癌发生中卵圆细胞的变化．世界华人消化杂志，2006，14(29)：2830-2833
[7] 索金友，顾红光，等．原发性肝癌中CK7的表达及意义．消化外科，2005，4(2)：128-131
[8] 肖家诚，金晓光，等．肝细胞肝癌和肝硬化组织中卵圆细胞：电镜与免疫电镜研究．检验医学，2004，01-0047-04
[9] 顾美珍，等．乙型肝炎病毒相关肝硬化组织中卵圆细胞形态和数最研究．南通大学学报，2006，03-0190-03
[10] 孙超，等．人类肝硬化组织中卵圆细胞形态与数量的研究．中华肝胆外科杂志，2006，12(5)：123-125
[11] 袁芳平，等．人肝病变组织低分子角蛋白CK19的表达．Journal of Fujian Medi cal Univercity，2001，35(2)：214-216
[12] 刘军，等．肝细胞肝癌和肝硬化组织中增殖细胞核抗原Ki-67抗原的表达及意义．山东医药，2003，43(12)26-29
[13] 王顺祥，等．Hpa与肝癌的侵袭转移、预后和Ki-67表达的临床意义．中国肿瘤临床，2005，32(3)：6-9
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