Immunohistochemical Study of Glypican-3 and HepPar-1 in Differentiating Hepatocellular Carcinoma from Metastatic Carcinomas in FNA of the Liver

Abstract

Hepatocellular carcinoma (HCC) remains a common malignant cancer worldwide, it is considered the fifth most common malignant cancer. On the other hand, metastatic tumors are widespread in the liver , with metastatic adenocarcinoma (MA) constituting the greatest part, therefore differentiation of HCC from MA is a frequent problem facing the pathologist especially in liver fine-needle aspiration biopsies. Evaluating the diagnostic value of glypican-3 (GPC-3) and HepPar-1 immunostaining in differentiating hepatocellular carcinoma from metastatic tumors in liver cell block material. Fourty eight cell blocks prepared from FNA from the liver ( 30 cases HCC, 18 cases metastatic carcinoma in liver) stained by Glypican -3 and HepPar-1 immunohistochemical markers. Glypican-3 was immunoexpressed in 97% of cases of HCC while all cases of metastatic carcinoma were negative. HepPar-1 was expressed in 93% of cases of HCC and 11% of metastatic carcinoma of the liver. In this study the sensitivity of GPC3 in the diagnosis of HCC in cytological material was 96.7% and the specificity was 100% while the sensitivity and specificity of HepPar-1 was 93.3% and 88.9% respectively. Immunohistochemical staining for GPC-3 in cell block material of the liver is highly sensitive and specific and it is a valuable tool capable of differentiating HCC from most of metastatic tumors of the liver.

Diagnostic Discrimination of Fine Needle Aspiration Specimens of Hepatic Nodules using Immunohistochemical Expression of GPC3 and EZH2

“…We found that GPC3 is highly specific for HCC, but not expressed in any of the metastatic nodules, with relatively high accuracy in differentiation between the two kinds of liver malignancy. This is consistent with the results obtained by previous related studies [39]. On the other hand, EZH2 was expressed in most of HCCs and in all metastasis.…”

Advances in the study of oncofetal antigen glypican-3 expression in HBV-related hepatocellular carcinoma

“…Thus, GPC-3 should be a specific biomarker for diagnosis of HCC. An examination of hepatic fine needle aspirates (FNA) found that GPC-3 immunoreactivity was from 83% to 90% in cases of HCC, whereas there was no reaction in any benign lesions or metastatic carcinomas (36,37). The usefulness of GPC-3 when examining specimens is as an aid to distinguish HCC from metastatic tumors and benign liver lesions.…”

Hepatocyte differentiation markers in adenocarcinoma of the prostate: hepatocyte paraffin 1 but not arginase-1 is specifically expressed in a subset of prostatic adenocarcinoma

“…To date, a variety of markers have proven highly sensitive and relatively specific for HCC and for carcinomas with hepatoid differentiation. Among these immunomarkers, hepatocyte paraffin 1 (HepPar-1) [4][5][6][7], arginase-1 (Arg-1) [8][9][10], AFP [10], glypican-3 [11] and SALL4 [12,13] have been extensively studied but data on expression of these markers in prostate cancer are very limited. Facing a consult case of primary prostatic adenocarcinoma showing prominent expression of HepPar-1 in a predominant solid component lacking conventional…”