| Summary: | 碩士 === 高雄師範大學 === 生物科技系 === 98 === Hepatocellular carcinoma(HCC) is one of the five popular malignant tumors in the world and is accounting for more than 5% of all cancers. Currently, there are three tools for the diagnosis of HCC, including biopsy, the traditional cytology and cell wax block. However, they have their shortcomings. In addition to lack of capacity for re-use of the specimen and correct diagnosis of well-differentiated HCC, the cellular morphology may be changed due to squeeze in process of making the conventional smear. In contrast to the conventional smear, in a manner of thin layer of liquid preparation, users are able to eliminate the above shortcomings. In addition, unchanged cellular morphology in thin layer of liquid preparation and CD34 immunostaining will increase the accuracy of diagnosis of HCC. CD34 is a 110 kDa transmembrane sialomucin glycoprotein. CD34 is usually not expressed in lining endothelial cells of sinusoids of the liver, but is expressed diffusely or CD34 (2 +) in HCC. Three categories for assessment of hepatocellular carcinoma by Immunohistochemistry in a manner of thin layer of liquid preparation were designed. Eighty cases were analyzed in this study, including 37 cases of benign lesions and 43 cases of hepatocellular carcinoma. In 37 benign lesions, three were diffusely positive, two were partially positive and 32 were not stained, immunohistochemically. In 43 cases of HCC, there were 5 well-differentiated HCC and 38 moderately-differentiated HCC. In 43 cases of HCC, 37 were diffusely positive (about 86.05%), and the remaining 6 cases, 5 were partially positive and the other one (WD-HCC) was negative. Generally, there was little difference in nuclear details, pseudoinclusion, fatty changes and mitoses, etc. between thin layer of liquid preparation and traditional cytology. However, in thin layer of liquid preparation, the cells were easily overlapped and arranged in three-dimensional patterns which should be distinguished from glands-forming malignancy. Computer-assisted cycle testing method was conducted to measure the nuclear areas, cell areas, nuclear diameters and nuclear density in thin layer of liquid preparation and traditional cytology, respectively. The nuclear areas were 47.75 ± 17.86 μm² and 57.54 ± 23.21 μm² (P <0.001), respectively. The cell areas were 148.66 ± 50.53 μm² and 207.30 ± 130.33 μm² (P <0.001), respectively. Therefore, the result of verifying the N/C ratios were 33.76 ± 10.56% and 30.67 ± 9.91%, respectively. The core diameters of the largest and smallest (diameter L / S ratio) were 1.27 ± 0.14 and 1.28 ± 0.17, respectively, indicating no significant difference (P> 0.05). The nuclear stain values (density ratio) were 3.95 ± 0.79 and 4.08 ± 0.68, respectively. The color of the nucleus seemed heavier in thin layer of liquid preparation than in traditional cytology, but the statistical analysis of nuclear density showed no significance (P> 0.05). A new method such as thin layer of liquid preparation can provide an alternative preparation method, because it exhibits up to 97% sensitivity and 86.5% specificity. We found that thin layer of liquid preparation combined with CD34 immunostaining might be an another choice for diagnosis of HCC.
|
|---|
