Histopathological characteristics of needle core biopsy and surgical specimens from patients with solitary hepatocellular carcinoma or intrahepatic cholangiocarcinoma

Abstract

BACKGROUND Pathological manifestations of hepatic tumours are often associated with prognosis. Although surgical specimens (SS) can provide more information, currently, pre-treatment needle core biopsy (NCB) is increasingly showing important value in understanding the nature of liver tumors and even in diagnosis and treatment decisions. However, the concordance of the clinicopathological characteristics and immunohistochemical (IHC) staining between NCB and SS from patients with hepatic tumours were less concerned. AIM To introduce a more accurate method for interpreting the IHC staining results in order to improve the diagnostic value of hepatic malignancy in NCB samples. METHOD A total of 208 patients who underwent both preoperative NCB and surgical resection for hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (ICC) between 2008 and 2015 were enrolled in this study. The expression of CK19, GPC3, and HepPar1 were detected by IHC staining. Clinicopathological, NCB, and surgical data were collected and analysed using χ 2 and kappa statistics. RESULTS Morphologically, the presence of compact tumour nests or a cord-like structure in NCB was considered the primary cause of misdiagnosis of HCC from ICC. The kappa statistic showed a moderate agreement in histomorphology (k = 0.504) and histological grade (k = 0.488) between NCB and SS of the tumours. A 4-tier (+++, ++, +, and -) scoring scheme that emphasized the focal neoplastic cell immunoreactivity of tumour cells revealed perfect concordance of CK19, GPC3 and HepPar1 between NCB and SS (k = 0.717; k = 0.768; k = 0.633). Furthermore, with the aid of a binary classification derived from the 4-tier score, a high concordance was achieved in interpreting the IHC staining of the three markers between NCB and final SS (k = 0.931; k = 0.907; k = 0.803), increasing the accuracy of NCB diagnosis C (k = 0.987; area under the curve = 0.997, 95%CI: 0.990-1.000; P < 0.001). CONCLUSION These findings imply that reasonable interpretation of IHC results in NCB is vital for improving the accuracy of tumour diagnosis. The simplified binary classification provides an easy and applicable approach.

Extracellular volume fraction using contrast-enhanced CT is useful in differentiating intrahepatic cholangiocellular carcinoma from hepatocellular carcinoma

“…Tumor biopsy is not routinely used because of its invasiveness and concern regarding procedure-related complications (16)(17)(18)(19). There is also the possibility of misdiagnosis due to sampling errors in percutaneous liver biopsy (20)(21)(22).…”

NTF3 Correlates With Prognosis and Immune Infiltration in Hepatocellular Carcinoma

“…Core biopsy, as a new diagnostic method, shows great potential value in judging the character of liver tumor. Two studies confirmed the feasibility of core biopsy in the diagnosis of liver tumor through staining with tumor markers such as cytokeratin-19, glypican-3 (GPC3), hepatocyte paraffin-1, arginase-1, AFP, pCEA and CD10 (23,24). Despite continuous improvements in diagnostic and treatment methods, In our study, we first used HCCDB database to analyze the difference in NTF3 expression between liver cancer tissues and normal tissues.…”

Prognostic significance of gamma‐glutamyl transpeptidase to albumin ratio in patients with intrahepatic cholangiocarcinoma after hepatectomy

“…A new diagnostic method called core biopsy has displayed potential value in judging the character of ICC. 33 The prognosis of ICC remains poor despite the use of highly effective diagnostic tools and treatment methods. It is urgent to find effective prognostic markers for ICC patients.…”

“…The treatment and prognosis of ICC is still a thorny issue. A new diagnostic method called core biopsy has displayed potential value in judging the character of ICC 33 …”