白蛋白mRNA检测在肝细胞癌和肝内胆管癌病理诊断中的应用OA

Objective To investigate the diagnostic value of albumin Super-ISH in the pathological diagnosis and differential diagnosis of hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC).Methods A total of 207 tumor specimens,including 53 HCCs,28 ICCs,9 combined hepatocellular-cholangiocarcinomas(cHCC-CCs),and 117 malignant epithelial tumors from various organs,as well as 6 normal liver tissue samples,were ana-lyzed.Albumin mRNA expression was detected using Super-ISH and systematically evaluated.Results Among HCCs,52 of 53 cases(98.1%)were positive for albumin mRNA,with strong diffuse staining observed in 90.6%(48/53).No significant differences were observed in albumin mRNA expression with respect to primary versus metastatic lesions,degree of differentiation,tissue block size,or storage duration of paraffin-embedded tissues(all P>0.05).Immunohistochemically,the positive rates of hepatocyte paraffin 1(HepPar-1),arginase-1(Arg-1),and glypican-3(GPC-3)in HCCs were 79.2%(42/53),84.9%(45/53),and 69.8%(37/53),respectively;in poorly differentiated primary HCCs,the corresponding rates were 68.4%(13/19),78.9%(15/19),and 73.7%(14/19).The sensitivi-ties of these three markers were all lower than that of albumin mRNA.Albumin mRNA expression was detected in 6 of 28 ICCs(21.4%),all of which were small bile duct subtypes,whereas no expression was observed in large bile duct subtypes.Among cHCC-CCs,8 of 9 cases(88.9%)were positive,showing diffuse expression in the HCC component and heterogeneous expression in the cholangiocarcinoma component.Albumin mRNA was diffusely or focally positive in 7 of 19 hepatoid adenocarcinomas(36.8%).Among the other 18 different types of malignant epithelial tumors of multiple organs,only one pancreatic acinar cell carcinoma and one yolk sac tumor exhibited focal albumin mRNA ex-pression.In this cohort,the sensitivity and specificity of albumin mRNA for diagnosing HCC were 98.1%(52/53)and 85.1%(131/154),respectively,while those for diagnosing ICC were 21.4%(6/28)and 61.5%(110/179).Conclusion Albumin Super-ISH demonstrated high sensitivity and specificity for identifying HCC and showed stable performance across tumors of different differentiation grades,tissue sizes,and storage durations,supporting its signifi-cant diagnostic and differential diagnostic value.Albumin mRNA expression was helpful in distinguishing ICC sub-types but was not a highly sensitive marker for ICC.