Hep Par 1 Antibody Stain for the Differential Diagnosis of Hepatocellular Carcinoma: 676 Tumors Tested Using Tissue Microarrays and Conventional Tissue Sections

“…In the last few years, Hep Par 1 has emerged as a sensitive and relatively specific marker of hepatocellular differentiation. [1][2][3][4] Polyclonal carcinoembryonic antigen (CEA) yields a characteristic canalicular pattern of staining that is considered specific for hepatocellular differentiation. 5,6 MOC31 has emerged as a useful marker as it is expressed in virtually all adenocarcinomas and is negative or weakly positive in hepatocellular carcinoma.…”

mentioning

confidence: 99%

Utility and limitations of glypican-3 expression for the diagnosis of hepatocellular carcinoma at both ends of the differentiation spectrum

2008

View full text Add to dashboard Cite

Glypican-3 is a heparin sulfate proteoglycan normally expressed in fetal liver and placenta, but not in normal adult liver. Preliminary studies have shown that glypican-3 can be useful for the diagnosis of hepatocellular carcinoma. We performed immunohistochemistry for glypican-3 on 80 resection cases of hepatocellular lesions to examine the utility of glypican-3 immunohistochemistry in hepatocellular carcinoma at two ends of the differentiation spectrum. Staining was compared to Hep Par 1 in poorly differentiated cases. Glypican-3 was expressed in 46 (79%) hepatocellular carcinomas (56, 83 and 89% of well, moderately and poorly differentiated respectively) and seven (64%) fibrolamellar carcinomas. Of the 16 well differentiated cases, 10 closely resembled adenoma and were diagnosed due to focal abnormalities and/or loss of reticulin. Glypican-3 expression was seen in 50% in this group. Hepatocellular carcinomas arising in cirrhotic liver were more likely to be glypican-3 positive (91 vs 57%, P ¼ 0.004). All hepatic adenomas and macroregenerative nodules were negative, and three (43%) high grade dysplastic nodules were positive. Focal staining was seen in regenerative nodules in four (11%) cirrhosis cases. Glypican-3 was significantly more sensitive than Hep Par 1 for diagnosis of poorly differentiated hepatocellular carcinomas (89 vs 63%, P ¼ 0.02). The difference was more significant when only cases with diffuse positive staining were considered (83 vs 21%, Po0.001). In conclusion, glypican-3 has high sensitivity for the diagnosis of hepatocellular carcinoma, but is less sensitive in the extremely well differentiated hepatocellular carcinoma and fibrolamellar variant of hepatocellular carcinoma. Caution should be exercised in using glypican-3 in biopsy specimens as cirrhotic nodules can show strong expression. Glypican-3 can be especially useful in the identification of poorly differentiated hepatocellular carcinoma as it has higher sensitivity compared to Hep Par 1.

show abstract

“…The most difficult histological differentiation is between poorly differentiated HCC and adenocarcinoma [7,9] . In this setting, arginase-1 exhibited higher sensitivity than HepPar-1, which demonstrated low immunoreactivity in poorly differentiated HCCs (40%).…”

Section: 10mentioning

confidence: 99%

“…It is bound to the plasma membrane through a glycosyl phosphatidyl-inositol (GPI) anchor. It is specifically appeared in fetal hepatoblasts and is silenced in normal tissues of adult liver [9] . Its expression tends to reappear with malignant transformation [10] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Immunohistochemical Distinction of Hepatocellular Carcinoma Using Arginase-1, Hepatocyte Paraffin Antigen -1 and Glypican-3

Hegazy

2016

Journal of Tumor

View full text Add to dashboard Cite

of MC and negative in all cases of CC. Arginase-1 was more sensitive (87.5%) than HepPar-1 (71.9%) or GPC-3 (65.6%) for HCC. GPC-3 was more specific (93.8%) than HepPar-1 (87.5%) and arginase-1 (90.6%). However, the combination of the three biomarkers for the diagnosis of HCC raised the specificity to 100%. CONCLUSION: Arginase-1 and HepPar-1 are effective biomarkers for HCC differentiation. Also, arginase-1 demonstrates a superior sensitivity in comparison with GPC-3 and HepPar-1 in the diagnosis of HCC, whereas GPC-3 demonstrates superior specificity. Hence, the use of combination of arginase-1 with HepPar-1 and GPC-3 could be useful in the precise diagnosis of HCC and distinguishing it from non-HCC. INTRODUCTIONHepatocellular Carcinoma (HCC) is the most common primary cancer of liver, representing the third most common cause of cancer deaths all over the world [1] . Egypt has a high prevalence of HCC; it is the second most cancer site among males after cancer bladder and seventh among females [2] . Such high incidence has been attributed to the high prevalence of hepatitis C virus (HCV) amongst Egyptians [3] .Based on histological characters, most HCCs can be easily identified on hematoxylin and eosin stained sections. However, some types of benign and malignant tumors may share the morphologic features. HCC mimickers include some cases of adrenocortical carcinoma, renal cell carcinoma (RCC), large cell neuroendocrine carcinoma, clear cell sarcoma, melanoma and angiomyolipoma [4,5] . In ABSTRACT AIM: The distinction of hepatocellular carcinoma (HCC) from the metastatic carcinoma (MC) and intrahepatic cholangiocarcinoma (CC) often presents a diagnostic challenge that carries a significant impact on its subsequent management. In this study we aimed to evaluate the immunohistochemical expressions of arginase-1, hepatocyte paraffin antigen-1 (HepPar-1), and glypican-3 (GPC-3) in a trial to distinguish HCC from non-HCC involving the liver. MATERIALS AND METHODS:The study included 64 cases (32 HCC, 28 MC and 4 CC) and 5 specimens of normal liver tissues. These cases were investigated retrospectively from the archive of the Pathology Department, Zagazig University Hospitals. The predictive capacity of arginase-1, HepPar-1 and GPC-3 staining was determined using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) calculations. RESULTS: Both arginase-1 and HepPar-1 expressions were present in all cases of non-neoplastic hepatocellular tissues, whereas GPC-3 expression was absent in all cases. Only two of 28 (7.1%) cases of MC and one of 4 (25%) cases of CC showed positive immunoreactivity for arginase-1. HepPar-1 immunoreactivity was detected in 3 of 28 (10.7%) cases of MC and in one of 4 (25%) cases of CC. GPC-3 immunoreactivity was detected in 2 of 28 (7.1%) cases

show abstract

Hep Par 1 Antibody Stain for the Differential Diagnosis of Hepatocellular Carcinoma: 676 Tumors Tested Using Tissue Microarrays and Conventional Tissue Sections

Cited by 216 publications

References 13 publications

Cholangiocarcinoma at the Cystic Duct Discovered by Lymph Node Metastases with Clear Cell Transformation

Cholangiocarcinoma at the Cystic Duct Discovered by Lymph Node Metastases with Clear Cell Transformation

Utility and limitations of glypican-3 expression for the diagnosis of hepatocellular carcinoma at both ends of the differentiation spectrum

Immunohistochemical Distinction of Hepatocellular Carcinoma Using Arginase-1, Hepatocyte Paraffin Antigen -1 and Glypican-3

Contact Info

Product

Resources

About