Differential Diagnostic Value of GPC3-CD34 Combined Staining in Small Liver Nodules With Diameter Less Than 3 cm

Abstract

The diagnostic value of combining glypican-3 (GPC3) and CD34 staining for small nodules in liver biopsy specimens has not been evaluated. In this study, 201 thin-core biopsy specimens were assessed using GPC3 and CD34 immunochemical staining, including 33 cirrhotic regenerative nodules, 31 high-grade dysplastic nodules, 70 hepatocellular carcinomas (HCCs) with nodules 3 cm or smaller, and 67 HCCs with nodules larger than 3 cm. The results showed that the accuracy of GPC3 staining (90.3%) among liver nodules 3 cm or smaller was better than its use among all nodules (P = .045). Furthermore, the positive expression rate of costaining was significantly greater than that observed for GPC3 or CD34 single staining (P < .001 and P = .002, respectively). These data demonstrate that GPC3 staining is more accurate for the diagnosis of HCC on thin-core biopsy specimens in nodules 3 cm or smaller compared with its use in all nodules, while GPC3 and CD34 costaining has better diagnostic value than does single staining.

Glypican‐3: a marker and a therapeutic target in hepatocellular carcinoma

“…Similar results were obtained later by many laboratories around the world . Some of these studies included thin‐core biopsy specimens and early stage HCCs . Consequently, a report of the International Consensus Group for HCC on the pathologic diagnosis of early HCC stated that ‘GPC3 immunoreactivity has a reported sensitivity of 77% and specificity of 96% in the diagnosis of small HCC; therefore, GPC3 positivity is a strong argument for malignancy’ .…”

Suppression of postsurgical recurrence of hepatocellular carcinoma treated with autologous formalin‐fixed tumor vaccine, with special reference to glypican‐3

“…GPC3, a heparan‐sulfate proteoglycans linked to the outer surface of cell membrane via a glycosylphosphatidylinositol anchor , is frequently overexpressed in HCC and in precancerous lesions in the liver . For this reason, a recombinant humanized monoclonal antibody against GPC3 and a GPC3‐peptide vaccine have been developed for treatment of HCC.…”

Arginase-1 is a Novel Immunohistochemical Marker of Hepatocellular Differentiation

“…In a recent immunohistochemical study in which a wide range of normal tissues were investigated, glypican 3 expression was demonstrated only in gastric glands, kidney tubules, and testicular germ cells, but not in any of the other tissues investigated, including the liver. 40,41,43,[47][48][49][50]54,58 In all of these cases, however, the staining was described as being focal and/or weak. In a review of 74 hepatoblastomas from 3 published studies, all (100%) of these tumors were reported to be glypican 3 positive.…”

“…In a combined review of 6 comparative studies, arginase-1 positivity was demonstrated in 428 (91%) of 471 hepatocellular carcinomas, whereas 359 (75%) of 477 such cases were found to express Hep Par 1 (Table 3). 11,34,35,40,41,[43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60] This marker is not expressed in hepatocellular adenomas, 34,41,43,47,49,[52][53][54][55]60 but it has been reported, although very rarely, in focal nodular hyperplasia. It is a membrane-bound heparan sulfate proteoglycan that is normally expressed in trophoblasts and a wide variety of fetal tissues, but its expression is limited in normal adult tissues.…”