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目的 :观察基膜中Ⅳ型胶原 (CoⅣ )及Laminin(LM )在人体慢性肝病和肝细胞癌 (HCC)的病理形态学改变 ,并探讨其临床病理意义。方法 :对 11例慢性肝炎、2 6例肝硬化和 30例人体HCC组织进行了CoⅣ和LM的免疫组化检测 ,系统地观察基膜成分在正常、慢性肝病和肝癌中的形态和数量的改变 ,行半定量计数 ,对其结果进行临床病理分析。结果 :正常肝窦无LM的表达 ,CoⅣ沿窦壁呈断续弱阳性表达 ,慢性肝病时可有少量LM弱阳性 ,肝硬化时CoⅣ阳性增强 ,沿窦壁呈均匀的连续线状阳性。HCC时窦壁CoⅣ及LM的阳性表达明显增强 ,在低分化癌及有门静脉癌栓的癌组织中基膜表达有所减少 ,易见断裂及缺失。LM和CoⅣ在癌组织与非癌性肝组织的表达有显著性差异。临床病理资料分析显示 ,CoⅣ的表达在HCC低分化组明显减少 ,有门静脉癌栓组CoⅣ和LM表达均有减少。结论 :CoⅣ和LM是鉴别肝癌与非癌性肝组织的参考指标。肝癌中基膜的断裂、缺失及减少可能参与癌细胞的转移机制。
OBJECTIVE: To observe the pathological changes of type Ⅳ collagen and Laminin in human chronic liver disease and hepatocellular carcinoma (HCC) and to investigate the clinicopathological significance. Methods: Immunohistochemical detection of Co Ⅳ and LM in 11 cases of chronic hepatitis, 26 cases of liver cirrhosis and 30 cases of human HCC tissues was carried out to systematically observe the change of morphology and quantity of basement membrane components in normal, chronic liver disease and liver cancer , The line of semi-quantitative count, the results of clinical and pathological analysis. Results: The normal sinusoids had no expression of LM. CoⅣwere weakly positive and weakly positive along the sinus wall. A small amount of LM was weakly positive in patients with chronic liver disease. Co Ⅳ was positive in cirrhosis and positive in the continuous sinusoid. The positive expression of CoⅣ and LM in the sinus wall was significantly increased in HCC. The expression of basement membrane in cancerous tissues with poorly differentiated carcinoma and portal vein tumor thrombus decreased, and the ruptures and deletions were easily seen. There was a significant difference in the expression of LM and Co Ⅳ between non-cancerous and non-cancerous liver tissues. Clinicopathological data analysis showed that the expression of CoⅣ was significantly decreased in HCC poorly differentiated group, and the expression of Co Ⅳ and LM in portal vein thrombosis group were decreased. Conclusion: Co Ⅳ and LM are the reference indexes for distinguishing liver cancer from non-cancerous liver. The rupture, deletion and decrease of basement membrane in liver cancer may participate in the metastasis mechanism of cancer cells.