| PurposeGuangxi is a high incidence area of Primary hepatocellular carcinoma (HCC). The early diagnosis and treatment of HCC is very important to improve the survival rate of patients. It’s difficult to diagnose the nodular lesions with smaller size in the HCC screening. Common hepatocellular nodular lesions consist of focal nodular hyperplasia (FNH), hepatocellular adenoma (HA), dysplastic nodules (DN) and HCC. These different lesions, the prognoses are different. FNH and HA are both benign lesions. The prognosis of low grade DN was good, all it need was follow-up. High grade DN is a borderline lesion and closely related with HCC, and HCC is a malignant disease. Glypican-3 (GPC3) is a member of membrane heparin sulfate family, is highly expressed in human embryonic and fetal stage and in the placenta in adult, and lowly expressed in a small number of organizations. The expression of GPC3 was negative in normal liver tissues, liver cirrhosis tissues and all benign nodular lesions, such as HA、 FNH. The sensitivity of GPC3 in low grade DN was 7.0%, and was 23.0% in high grade DN. The expression of GPC3 was high in HCC. Heat shock protein 70 (HSP 70), a kind of stress protein, is expressed in various organs of human body. Its biological function is mainly involved in the synthesis, modification and transport of proteins, and effect on anti-apoptosis. The expression of HSP70 increased gradually in the development procedure of HCC. GPC3 and HSP70 play different roles in different malignant tumors. There is no study on the expression of GPC3 and HSP70 in series of hepatocellular nodular lesions or the the relationship with the prognosis yet. In this study, the expression of GPC3 and HSP70 protein in hepatocellular nodular lesions was detected by immunohistochemistry, analyse the relationship between the expression of GPC3 and HSP70 and prognosis of patients. Furthermore, we investigate the diagnostic value and prognostic significance of GPC3 and HSP70 in the diagnosis of hepatocellular nodular lesions.Methods(1) We collected the formalin-fixed, paraffin-embedded specimens of 110 cases of hepatocellular nodular lesions tissues from the Department of Pathology of the Affiliated Tumor Hospital of GuangXi Medical University between July, 2010 and June,2015. Including 21 cases of FNH,10 cases of, HA,13 cases low grade DN (including 11 cases of sources in adjacent tissues to HCC),34 cases of high grade DN (including 24 cases of sources in adjacent tissues to HCC) and 32 cases of well-differentiated HCC (of which 20 cases combine DN in adjacent tissues,5 cases were low grade DN and 15 cases were high grade DN). Follow-up data were collected.(2) IHC was performed to detect the expression of GPC3 and HSP70 protein in 5 groups of cases. Analyse the differences of expression of GPC3 and HSP70 in 5 groups of cases using X2 test or exact probability test.(3) Analysis of the influence of GPC3 and HSP70 on the prognosis of patients.Results(1) The rate of positive expression of GPC3 was 0% (0/21) in focal nodular hyperplasia,0% (0/10) in hepatocellular adenoma,7.69%(1/13) in low grade dysplastic nodule,14.71% (5/34) in high grade dysplastic nodule, 59.38%(19/32) in well-differentiated hepatocellular carcinoma. The rate of positive expression of HSP70 was 9.52%(2/21) in focal nodular hyperplasia, 0% (0/10) in hepatocellular adenoma,0%(0/13) in low grade dysplastic nodule, 20.59% (7/34) in high grade dysplastic nodule,62.5% (20/32) in well-differentiated hepatocellular carcinoma. The rate of positive expression of GPC3 and HSP70 in non cancerous nodular lesions and in well-differentiated hepatocellular carcinoma tissue were obviously different (P＜0.05).(2) There were no significant differences (P>0.05). in positive rate of GPC3 and HSP70 in FNH, HA, low grade DN, high grade DN in pairwise.(3) 17 cases were normal,3 cases were lost and 1 case died of other causes in 21 cases of FNH; 8 cases were normal,1 case got HCC and lease died of other causes in 10 cases of HA; In 13 cases of low grade DN,2 cases were not sources in adjacent tissues to HCC, one of them was normal and the other got hepatocirrhosis and 11 cases were sources in adjacent tissues to HCC,7 of them were normal,3 of them were died and 1 was lost; In 34 cases of high grade DN,10 cases were not sources in adjacent tissues to HCC,6 of them were normal and 4 of them got HCC, all of them were alive and 24 cases were sources in adjacent tissues to HCC,12 of them were alive,10 of them were died and 2 were lost; 13 cases were alive,16 cases were died and 3 cases were lost in 32 cases of well-differentiated HCC.Conclusion(1) GPC3 and HSP70 are lowly expressed or no expression in non cancerous nodular lesions and highly expressed in HCC, suggesting that GPC3 and HSP70 have important significance in the identification of begign and malignant hepatocellular nodular lesions.(2) The expression of GPC3 and HSP70 in 4 groups of non cancerous nodules in pairwise comparison was not statistically significant (.P>0.05), so GPC3 and HSP70 can not be effective indicators for the differential diagnosis in these 4 diseases.(3) The mortality rate of GPC3 and HSP70 positive patients was higher than that both negative patients, but the difference was not statistically significant (P>0.05). It was not considered that GPC3 and HSP70 positive were the influencing factors of poor prognosis of HCC. |
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