Histopathological Diagnosis of Early HCC through Biopsy: Efficacy of Victoria Blue and Cytokeratin 7 Staining

Kobayashi, Sho; Kim, Soo Ryang; Imoto, Susumu; Ando, Kenji; Hirakawa, Makoto; Saito, Jun; Fukuda, Katsumi; Otono, Yumi; Sakaki, Madoka; Tsuchida, Shinobu; Kim, Soo Ki; Hayashi, Yoshitake; Nakano, Masayuki; Kudo, Masatoshi

doi:10.1159/000343069

Cited by 13 publications

(8 citation statements)

References 19 publications

(10 reference statements)

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“…A significant difference has been observed in the sensitivity between CECT and CT arterioportal angiography, but not among Sonazoid-enhanced US, Gd-EOB-DTPA MRI and CT arterioportal angiography. The authors have concluded that changing the main diagnostic modality for HCCs that are smaller than 2 cm from CT arterioportal angiography to Sonazoid-enhanced US and Gd-EOB-DTPA MRI is recommended [23]. …”

Section: Discussionmentioning

confidence: 99%

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Characteristics of Hypovascular versus Hypervascular Well-Differentiated Hepatocellular Carcinoma Smaller Than 2 cm - Focus on Tumor Size, Markers and Imaging Detectability

Sugimoto¹,

Kim

Imoto

et al. 2015

Dig Dis

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Objectives: The characteristics of hypovascular and hypervascular well-differentiated hepatocellular carcinomas (HCCs) were compared in terms of tumor size, tumor markers and detectability by imaging modalities. Methods: Well-differentiated HCC nodules that are smaller than 2 cm (n = 27) were evaluated in 27 patients using histopathology and divided into 2 groups: hypovascular (n = 10) and hypervascular (n = 17). The diagnostic sensitivity of imaging modalities was then evaluated for efficiency in disclosing tumor size and tumor markers in the 2 types. Results: No difference was observed in tumor size and tumor markers between the 2 types; however, the sensitivity of contrast-enhanced CT, contrast-enhanced ultrasonography and arterioportal angiography was significantly different between the 2 types, whereas that by Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging (Gd-EOB-DTPA MRI) demonstrated no difference. Conclusion: Hypovascular HCC could be diagnosed by Gd-EOB-DTPA MRI in the hepatobiliary phase.

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Section: Discussionmentioning

confidence: 99%

“…CK7 immunostaining is useful in identifying stromal invasion. Ductular reaction, confirmed by CK7 immunostaining, is frequently found in non-cancerous hepatocellular nodular lesions, whereas it is less frequently found in HCCs with true stromal invasion [23]. …”

Section: Discussionmentioning

confidence: 99%

Characteristics of Hypovascular versus Hypervascular Well-Differentiated Hepatocellular Carcinoma Smaller Than 2 cm - Focus on Tumor Size, Markers and Imaging Detectability

Sugimoto¹,

Kim

Imoto

et al. 2015

Dig Dis

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“…The international consensus group for hepatocellular neoplasia stated that the presence of stromal invasion (namely, tumor cell invasion into the intratumoral portal tracts)[18] should be recognized as the most important pathologic finding for the diagnosis of early HCCs. The diagnosis of stromal invasion is subjective and may require the assistance of Victoria blue staining[19] and immunohistochemical stains (cytokeratin 7)[19,20] to differentiate stromal invasion from pseudo-invasion. Thirty-nine patients with 54 nodules were diagnosed as having pathologically early HCC between December 2009 and July 2014, and 35 patients with 50 nodules who meet the study criteria were enrolled in the present study.…”

Section: Methodsmentioning

confidence: 99%

Rate of local tumor progression following radiofrequency ablation of pathologically early hepatocellular carcinoma

Hao¹,

Numata²,

Ishii³

et al. 2017

WJG

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AIMTo evaluate whether pathologically early hepatocellular carcinoma (HCC) exhibited local tumor progression after radiofrequency ablation (RFA) less often than typical HCC.METHODSFifty pathologically early HCCs [tumor diameter (mm): mean, 15.8; range, 10-23; follow-up days after RFA: median, 1213; range, 216-2137] and 187 typical HCCs [tumor diameter (mm): mean, 15.6; range, 6-30; follow-up days after RFA: median, 1116; range, 190-2328] were enrolled in this retrospective study. The presence of stromal invasion (namely, tumor cell invasion into the intratumoral portal tracts) was considered to be the most important pathologic finding for the diagnosis of early HCCs. Typical HCC was defined as the presence of a hyper-vascular lesion accompanied by delayed washout using contrast-enhanced computed tomography or contrast-enhanced magnetic resonance imaging. Follow-up examinations were performed at 3-mo intervals to monitor for signs of local tumor progression. The local tumor progression rates of pathologically early HCCs and typical HCCs were then determined using the Kaplan-Meier method.RESULTSDuring the follow-up period for the 50 pathologically early HCCs, 49 (98%) of the nodules did not exhibit local tumor progression. However, 1 nodule (2%) was associated with a local tumor progression found 636 d after RFA. For the 187 typical HCCs, 46 (24.6%) of the nodules exhibited local recurrence after RFA. The follow-up period until the local tumor progression of typical HCC was a median of 605 d, ranging from 181 to 1741 d. Among the cases with typical HCCs, local tumor progression had occurred in 7.0% (7/187), 16.0% (30/187), 21.9% (41/187) and 24.6% (46/187) of the cases at 1, 2, 3 and 4 years, respectively. Pathologically early HCC was statistically associated with a lower rate of local tumor progression, compared with typical HCC, when evaluated using a log-rank test (P = 0.002).CONCLUSIONThe rate of local tumor progression for pathologically early HCCs after RFA was significantly lower than that for typical HCCs.

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“…Decrease of reticular ber were evaluated using silver staining. By assistance of VB staining, intratumoral stromal invasion (tumor cell invasion into the intratumoral portal tracts [20]) for the diagnosis of early HCCs was determined [21]. We used the CK7 to stain the bile duct, which is a suggestive of change in bile metabolism in HCC [22].…”

Section: Current Used Descriptive Diagnosismentioning

confidence: 99%

Diagnostic Value of Immunohistochemical Markers in Four-grade Histological Classification of Hepatocellular Carcinoma

Wang

Numata

Nakano³

et al. 2020

Preprint

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Backgrounds: Accurate differential diagnosis regarding histological grades of hepatocellular carcinoma (HCC) is critical for targeted treatment and prognostic evaluation. However, the currently used descriptive diagnosis of histological grading have to observe tedious item of neovascularization, stromal invasion, cellular and structural atypia, which have drawbacks of subjectivity and error-prone. Immunohistochemical (IHC) markers-based diagnosis only needs to determine whether there is staining in the cell membrane, cytoplasm and / or nucleus. Using IHC markers targeted heat shock protein (HSP)70, glypican (GPC)3, glutamine synthetase (GS), and organic anion transport peptide (OATP), we sought to establish an easy method for the diagnosis of the histopathological grades and further explore the best efficacy by their combined or independent application.Methods: We retrospectively conducted a study of 157 patients with 200 histologically confirmed HCCs, which were classified into early (n= 45), well (n=31), moderately (n=68), and poorly (n=56) differentiated (diff.) HCC. The sensitivity, specificity, accuracy of HSP70, GPC3, GS and OATP on each histological grade were examined. Results: HSP70 and GPC3 showed difference in most histological grades of HCC ( P < 0.05). GS distinguished early HCC from three other histological grades (p < 0.01). OATP8 only differentiated early HCC from poorly diff. HCC (P=0.019). When any two of the three indicators (HSP, GPC3, and GS) were negatively expressed, the diagnostic efficacy of early HCC was the highest, with an area under the curve (AUC) of 0.802 and accuracy of 80.5%. The optimal efficacy for poorly diff. HCC detection was obtained when both GPC3 and HSP70 were positively expressed (74.4% accuracy; AUC = 0.703). However, for well and moderately diff. HCC, a relative satisfactory AUC value (>0.60) failed to yield either by the independent or combined diagnosis of any IHC indicators.Conclusion: Using GS, HSP70, and GPC3, early and poorly diff. HCC can be properly diagnosed. IHC markers might be a potential alternative tool for histological differential diagnosis of HCC.

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Histopathological Diagnosis of Early HCC through Biopsy: Efficacy of Victoria Blue and Cytokeratin 7 Staining

Cited by 13 publications

References 19 publications

Characteristics of Hypovascular versus Hypervascular Well-Differentiated Hepatocellular Carcinoma Smaller Than 2 cm - Focus on Tumor Size, Markers and Imaging Detectability

Characteristics of Hypovascular versus Hypervascular Well-Differentiated Hepatocellular Carcinoma Smaller Than 2 cm - Focus on Tumor Size, Markers and Imaging Detectability

Rate of local tumor progression following radiofrequency ablation of pathologically early hepatocellular carcinoma

Diagnostic Value of Immunohistochemical Markers in Four-grade Histological Classification of Hepatocellular Carcinoma

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