The application of markers (HSP70 GPC3 and GS) in liver biopsies is useful for detection of hepatocellular carcinoma

• Published in: Journal of hepatology 2009-04, Vol.50 (4), p.746-754
• Main Authors: Di Tommaso, Luca, Destro, Annarita, Seok, Jae Yeon, Balladore, Emanuela, Terracciano, Luigi, Sangiovanni, Angelo, Iavarone, Massimo, Colombo, Massimo, Jang, Ja June, Yu, Eunsil, Jin, So Young, Morenghi, Emanuela, Park, Young Nyun, Roncalli, Massimo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biomarkers, Tumor - analysis; Carcinoma, Hepatocellular - enzymology; Carcinoma, Hepatocellular - pathology; Differential diagnosis; Digestive system; Dysplastic nodules; Female; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Glutamate-Ammonia Ligase - analysis; Glypicans - analysis; Hepatocellular carcinoma; HSP70 Heat-Shock Proteins - analysis; Humans; Immunohistochemistry; Investigative techniques, diagnostic techniques (general aspects); Liver biopsy; Liver Neoplasms - enzymology; Liver Neoplasms - pathology; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Markers; Medical sciences; Middle Aged; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Tumors
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/j.jhep.2008.11.014

Background/Aims Liver biopsy for hepatocellular carcinoma (HCC) detection is largely restricted to small hepatocellular lesions, which are often morphologically challenging, requiring careful distinction between dysplastic nodules (high-grade) and well-differentiated HCC. Methods We investigated the diagnostic accuracy of a panel of markers (HSP70 GPC3 and GS), previously tested in resection specimens, in a series of liver biopsies of large regenerative nodules ( n = 13), low-grade dysplastic nodules ( n = 21), high-grade dysplastic nodules ( n = 50), very well-differentiated (VWD) ( n = 17), well-differentiated (WD-G1) ( n = 40) and G2-3 ( n = 35) HCC. Results Almost all cases of large regenerative and low-grade dysplastic nodules did not stain while high-grade dysplastic nodules showed 1 marker (22%) but never 2 or 3. For HCC detection the overall accuracy of marker combination was 60.8% (3 markers) and 78.4% (2 markers) with 100% specificity. When restricted to VWD + WD-G1 HCC the accuracy was 57% (3 markers) and 72.9% (2 markers) with 100% specificity. Conclusions This panel proved useful to detect well-differentiated HCC in biopsy. Two immunoreactive markers (out of 3) are recommended as the most valuable diagnostic combination for HCC detection. The diagnostic accuracy of the panel could be improved using additional markers, as suggested by studies of expression profiling in other human models.