先提供一篇文献再说：

Agrin and CD34 Immunohistochemistry for the Discrimination of Benign Versus Malignant Hepatocellular Lesions

Abstract
Agrin is a recently identified proteoglycan component of vascular and bile duct basement membranes in the liver. The selective deposition of agrin in hepatocellular carcinoma (HCC) microvessels versus sinusoidal walls prompted us to investigate the utility of agrin immunohistochemistry (IHC) in detecting malignant hepatocellular lesions. We focused on the differential diagnostic problems often presented by hepatocellular adenomas (HCAs) and dysplastic nodules. IHC for agrin was performed on 138 formalin-fixed, paraffin-embedded surgical specimens from 93 patients, including cirrhotic liver tissues (25), focal nodular hyperplasia (10), large regenerative nodules (8), low-grade (23) and high-grade (7) dysplastic nodules, small HCC (8), HCC (27), and HCA (30). Agrin immunostaining was compared with that of CD34 and, in selected cases, to glypican-3. The combination of agrin and CD34 sensitively (0.94) and specifically (0.93) identified lesions judged previously as malignant by histology. The majority of benign lesions were clearly agrin-negative, whereas the strength and extent of agrin IHC faithfully reflected dysplasia in atypical HCAs and in high-grade dysplastic nodules. Malignant lesions were uniformly positive. In conclusion, as agrin is highly selective for tumor blood vessels, IHC for agrin facilitates the discrimination of benign and malignant hepatocellular lesions. Moreover, whereas glypican-3 in some HCCs may appear in few scattered cells only, agrin is diffusely deposited in virtually all malignant lesions, which may prove advantageous in the evaluation of small specimens such as core biopsies.
The American Journal of Surgical Pathology:June2009 Volume33 Issue6 pp874-885

 非常好的论题！

我们鉴别HCC,需要做CD34,CD68,CD8/18,AFP,HEP,GPC-3等。

请问shiqian老师及各位老师：CD68,GPC-3在HCC鉴别中的作用？能否具体说说，谢谢！

 肝脏病理学中免疫组化染色是很重要的。在Washington University虽然特殊染色作为最重要的依据（Masson, PAS, 铜/铁染色），CK19是最重要的免疫组化指标（观察小胆管的变化）。而 具体的免疫组化的应用根据诊断的目的，个人粗略的分类如下：
1.病毒性肝炎病变：病毒学的检测，如HBS-Ag，CMV，EBV等；

2.自身免疫性肝炎或肝脏移植：PBS的小胆管改变，CK19;

3.肝脏代谢应疾病：如范素等的染色；

4.肝脏肿瘤，CD34,CK，特异性标记物（ER\PR\MCU\TTF-1等）系列鉴别转移性肿瘤；

 回答6楼老师提问：

 CD68在相对正常肝脏内，可以使Kupffer细胞染色，在肝窦内肝细胞之间排列较规则，

 而HCC时肿瘤细胞间没有此细胞，可有散在不规则的吞噬细胞阳性，与正常形态及排列均不同，可供参考。

 GPC-3我们用于染HCC的肿瘤细胞，效果不错，特别是极高分化的HCC，很有价值，

 如果再配上4楼老师提供的Agrin ，全无敌！

学习了，谢谢！

染HCV有比较好的抗体吗？