背景:具有各种恶性潜能的原发性恶性肝血管肿瘤包括上皮样血管内皮瘤(EHE)和血管肉瘤(AS),可能在病理上重叠。本研究旨在比较肝脏EHE与AS的病理结果。与患者预后相关。
方法:从2003年至2020年,在三级医院收治了59例经组织学证实的34例EHE和25例AS患者。比较其EHE和AS病理特征。CD31,ERG,在石蜡包埋的块上进行CAMTA-1、TFE3、P53和Ki-67标记。标记,连同组织学发现,通过多变量分析进行诊断和预后意义的分析。
结果:CAMTA-1在EHE中阳性为91.2%,但在AS中为阴性(p=<0.001)。AS与p53异常表达显着相关,高Ki-67标签,和高有丝分裂活性,与EHE相比(所有,p=<0.001)。使用有丝分裂活性和ki-67标记的预后值(灵敏度=1,特异性=1),可以将EHE分为低等级(LG)和高等级(HG)。低等级EHE显示总生存率明显优于高等级EHE(p=0.020)。
结论:CAMTA-1,P53和Ki-67标记的免疫组织化学可能有助于在组织学模糊的病例中区分EHE和AS,特别是小的活检组织。此外,有丝分裂活性和Ki-67标记的结合可以成为具有各种临床特征的EHE的预后因素。
BACKGROUND: Primary malignant hepatic vascular tumors with various malignant potentials include epithelioid hemangioendothelioma (EHE) and angiosarcoma (AS), which may overlap pathologically. This study aimed to compare the pathological findings of hepatic EHE with those of AS, in association with patient outcomes.
METHODS: Fifty-nine histologically confirmed patients with 34 EHE and 25 AS were admitted to a tertiary hospital from 2003 to 2020. Their EHE and AS pathological features were compared. Immunohistochemistry for CD31, ERG, CAMTA-1, TFE3, P53, and Ki-67 labeling was performed on paraffin-embedded blocks. Markers, along with histological findings, were analyzed for the purposes of diagnostic and prognostic significance by multivariate analysis.
RESULTS: CAMTA-1 was 91.2% positive in EHE, but negative in AS (p = < 0.001). AS was significantly correlated to an aberrant p53 expression, high Ki-67 labeling, and high mitotic activity, compared to EHE (all, p = < 0.001). EHE can be classified as low grade (LG) and high grade (HG) using the prognostic values of mitotic activity and ki-67 labeling (sensitivity = 1, specificity = 1). Low grade-EHE showed significantly better overall survival than high grade-EHE (p = 0.020).
CONCLUSIONS: Immunohistochemistry for CAMTA-1, P53, and Ki-67 labeling may help distinguish EHE and AS in histologically ambiguous cases, especially small biopsied tissue. Moreover, the combination of mitotic activity and Ki-67 labeling can be a prognostic factor for EHE with various clinical features.