腺瘤性增生和肝细胞癌的组织病理学和免疫组织化学分析:细胞结构、细胞索厚度和Ki-67增殖活性。

K W Than, I Okayasu, T Akashi
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摘要

为了确定腺瘤性增生(AH)和肝细胞癌(HCC)的特征,并确定它们的组织病理学差异,我们对HCV血清抗体阳性患者手术获得的肝病变进行了形态计量学和免疫组织化学分析,即细胞结构、细胞索厚度和Ki-67标记指数(Ki-67 LI)。分析的肝脏病变包括慢性活动性肝炎(CAH)(11例)、肝硬化再生结节(LC)(29例)、AH(11例)、小肝癌Edmondson's I级(GI)(19例)、GII(26例)、GIII(14例)。结果表明:AH细胞密度较高,细胞束厚度明显大于LC;而HCC GI的细胞含量和Ki-67 LI明显高于AH。根据这些标志物的数据,以及没有明显的结构异型性,AH被认为与HCC GI属于不同的类别。AH的癌前潜能仅因其与HCC GI或GII共存的高发生率而得到支持(6/11)。大多数HCC的病变似乎是从具有CAH或LC背景的肝组织发展而来,而不经过AH。局灶性脂肪改变在AH和HCC GI病变中都经常观察到(5/ 11,8 /19)。当比较AH和HCC GI的非脂肪区标志物,特别是Ki-67 LI,以及结构异型性,如微腺泡形成和假腺结构,以及浸润性生长到周围肝实质时,HCC GI可被诊断为早期或分化良好的恶性病变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Histopathological and immunohistochemical analysis of adenomatous hyperplasia and hepatocellular carcinoma: cellularity, thickness of cell cord, and Ki-67 proliferative activity.

To characterize adenomatous hyperplasia (AH) and hepatocellular carcinoma (HCC), and to establish their histopathological differences, morphometrical and immunohistochemical analyses, namely, cellularity, thickness of cell cord, and Ki-67 labeling index (Ki-67 LI) were done on surgically obtained hepatic lesions from patients with positive serum antibody against HCV. The hepatic lesions analyzed include chronic active hepatitis (CAH) (11 specimens), regenerative nodules of liver cirrhosis (LC) (29), AH (11), small HCC Edmondson's Grade I (GI) (19), GII (26), GIII (14). The results showed that AH has relatively high cellularity, and significantly greater thickness of cell cord than LC; whereas, HCC GI has significantly higher cellularity and Ki-67 LI than AH. From the data of these markers, and from the absence of conspicuous structural atypism, AH is considered to be in a different category from HCC GI. The premalignant potential of AH is supported only by its high incidence of coexistence adjacent to HCC GI or GII(6/11). Most lesions of HCC seem to develop from the liver tissue having a background of CAH or LC without passing through AH. Focal fatty changes are frequently observed within lesions of both AH and HCC GI (5/11, 8/19). When non-fatty regions of AH and HCC GI are compared, with respect to their markers, particularly Ki-67 LI, as well as the structural atypism, such as microacinus formation and pseudoglandular structure, and invasive growth into the surrounding liver parenchyma, HCC GI can be diagnosed as an early or well-differentiated malignant lesion.

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