Document Detail


Diagnostic utility of the HepPar1 antibody to differentiate hepatocellular carcinoma from metastatic carcinoma in fine-needle aspiration samples.
MedLine Citation:
PMID:  11836703     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The cytopathologic distinction between hepatocellular carcinoma (HCC) and metastatic carcinoma (MC) in the liver can be problematic, especially in patients with poorly differentiated HCC, in whom a trabecular pattern, bile production, and Mallory bodies may not be apparent on small fine-needle aspiration (FNA) samples. HepPar1 (OCH1E5) is a monoclonal antibody specifically developed to react with hepatocytes. It rarely reacts with bile duct and nonparenchymal liver cells. METHODS: FNA samples (cell blocks) from 75 liver tumors were selected. These included 50 moderate to poorly differentiated HCC cases, 5 cholangiocarcinoma (CC) cases, and 20 MC cases (4 from the breast, 4 from the stomach, 4 from the pancreas, and 8 from the colon). Immunohistochemical staining for HepPar1 was performed to differentiate HCC from MC. RESULTS: The HepPar1 antibody was positive in 50 of 50 HCC cases (100%). The positivity was cytoplasmic, diffuse, and granular. All 5 cases of CC were found to be negative (0%). Although focal positivity within tumor cells was noted in one case, cytologically these were entrapped normal hepatocytes between the tumor cells. In addition, 3 of 20 MC cases (15%) also were positive for HepPar1. All three cases originated from gastric primary tumors and exhibited diffuse, granular cytoplasmic staining. CONCLUSIONS: The results of the current study demonstrate that HepPar1 is an effective marker with which to differentiate between HCC and CC and/or MC. HepPar1 was found to demonstrate 100% positivity in HCC cases, compared with 0% and 15% positivity, respectively, in CC and MC cases. In addition, HepPar1 is extremely helpful in limited tissue samples from FNA. Although 15% of the MC cases in the current study were found to be positive, with the help of clinical correlation and other immunohistochemical stains a definite diagnosis could be rendered. Potential pitfalls include residual benign hepatocyte staining within a non-HCC malignancy, as was observed in one of the CC cases in the current study.
Authors:
Momin T Siddiqui; M Hossein Saboorian; S Tunc Gokaslan; Raheela Ashfaq
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Cancer     Volume:  96     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-02-11     Completed Date:  2002-03-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  49-52     Citation Subset:  AIM; IM    
Affiliation:
Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-2721, USA.
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal / diagnostic use
Biopsy, Needle
Breast Neoplasms / pathology
Carcinoma, Hepatocellular / diagnosis*,  immunology,  pathology
Cell Differentiation
Cholangiocarcinoma / diagnosis*,  immunology,  pathology
Colonic Neoplasms / pathology
Diagnosis, Differential
Hepatocytes
Humans
Immunohistochemistry
Liver Neoplasms / diagnosis*,  immunology,  secondary*
Pancreatic Neoplasms / pathology
Sensitivity and Specificity
Stomach Neoplasms / pathology
Tumor Markers, Biological / analysis*
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Tumor Markers, Biological

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