Application of Immunohistochemistry in the Pathological Diagnosis of Liver Tumors

Abstract

Although radiological diagnostics have been progressing, pathological diagnosis remains the most reliable method for diagnosing liver tumors. In some cases, definite pathological diagnosis cannot be obtained by histological evaluation alone, especially when the sample is a small biopsy; in such cases, immunohistochemical staining is very useful. Immunohistochemistry is the most frequently used technique for molecular pathological diagnosis due to its broad application, ease of performance and evaluation, and reasonable cost. The results occasionally reflect specific genetic mutations. The immunohistochemical markers of hepatocellular carcinoma include those of hepatocellular differentiation—such as hepatocyte paraffin 1 and arginase-1—and those of malignant hepatocytes—such as glypican-3, heat shock protein 70, and glutamine synthetase (GS). To classify the subtypes of hepatocellular adenoma, examination of several immunohistochemical markers, such as liver fatty acid-binding protein, GS, and serum amyloid A, is indispensable. Immunohistochemical staining for GS is also important for the diagnosis of focal nodular hyperplasia. The representative immunohistochemical markers of intrahepatic cholangiocarcinoma include cytokeratin (CK) 7 and CK19. In this article, we provide an overview of the application of immunohistochemistry in the pathological diagnosis of liver tumors referring to the association with genetic alterations. Furthermore, we aimed to explain the practical points in the differential diagnosis of liver tumors by immunohistochemical staining.

Laboratory Profile of COVID-19 Patients with Hepatitis C-Related Liver Cirrhosis

“…The inclusion criteria were set for patients diagnosed exclusively with non-alcoholic cirrhosis and non-overlapping diagnosis codes of chronic hepatitis B or other primary or secondary causes of cirrhosis. The diagnosis in all patients was priorly established through liver biopsy, so all patients with a secondary cause of cirrhosis other than chronic hepatitis C infection were excluded from the study after proper histopathologic immunohistochemical analysis of the liver samples [14,15].…”

Integrative Analysis of Intrahepatic Cholangiocarcinoma Subtypes for Improved Patient Stratification: Clinical, Pathological, and Radiological Considerations

“…The hepatocellular origin of a tumor may already be distinguished conventionally and morphologically by routine histopathology together with typical radiologic features and clinical context, as HCCs are most frequently associated with liver cirrhosis. In particularly difficult cases, as for certain types of HCCs as well as combined hepatocellular-cholangiocarcinoma (HCC-CCC), the diagnosis needs further immunohistochemical analyses such as Hepatocyte paraffin 1 (HepPar1) [24]. So far, the final histopathologic diagnosis of iCCA including its subtype is necessary for further therapy planning, even in unresectable cases [25].…”

Clinical relevance of biomarkers in cholangiocarcinoma: critical revision and future directions

“…Differential diagnosis with HCC is usually easy, unless the tumour is poorly differentiated. In this case, a wider IHC panel is recommended,11 which should include markers of hepatocyte differentiation, such as hepatocyte paraffin 1 (HepPar–1), arginase–1, alpha–fetoprotein, CD10 and polyclonal carcinoembryonic antigen or markers of malignant hepatocytes as glutamine synthetase, glypican 3 or heat shock protein 70 3…”