Background/Aims
Liver biopsy for hepatocellular carcinoma (HCC) detection is largely restricted to
small hepatocellular lesions, which are often morphologically challenging, requiring
careful distinction between dysplastic nodules (high-grade) and well-differentiated
HCC.
Methods
We investigated the diagnostic accuracy of a panel of markers (HSP70 GPC3 and GS),
previously tested in resection specimens, in a series of liver biopsies of large regenerative
nodules (n = 13), low-grade dysplastic nodules (n = 21), high-grade dysplastic nodules (n = 50), very well-differentiated (VWD) (n = 17), well-differentiated (WD-G1) (n = 40) and G2-3 (n = 35) HCC.
Results
Almost all cases of large regenerative and low-grade dysplastic nodules did not stain
while high-grade dysplastic nodules showed 1 marker (22%) but never 2 or 3. For HCC
detection the overall accuracy of marker combination was 60.8% (3 markers) and 78.4%
(2 markers) with 100% specificity. When restricted to VWD + WD-G1 HCC the accuracy was 57% (3 markers) and 72.9% (2 markers) with 100% specificity.
Conclusions
This panel proved useful to detect well-differentiated HCC in biopsy. Two immunoreactive
markers (out of 3) are recommended as the most valuable diagnostic combination for
HCC detection. The diagnostic accuracy of the panel could be improved using additional
markers, as suggested by studies of expression profiling in other human models.
Abbreviations:
VWD-HCC (very well-differentiated hepatocellular carcinoma), GPC3 (Glypican 3), HSP70 (heat shock protein 70), GS (glutamine synthetase)Keywords
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Article info
Publication history
Published online: December 18, 2008
Accepted:
November 17,
2008
Received in revised form:
October 14,
2008
Received:
July 14,
2008
Associate Editor: J.M. LlovetFootnotes
☆The authors declare that they do not have anything to disclose regarding funding from industries or conflict of interest with respect to this manuscript. This work was supported by a grant (0620210) from the National R&D Program for Cancer Control, Ministry of Health & Welfare, and by the Korea Science and Engineering Foundation (KOSEF) grant funded by the Korea government (MOST) (R13-2002-054-03004-0), Republic of Korea (Y.N. Park, J.J. Jang and E. Yu) and by the Italian MURST (FIRST 2006).
Identification
Copyright
© 2009 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
