title: Comparative immunohistochemical study of primary and metastatic carcinomas of the liver.
abstract: Distinguishing primary hepatocellular carcinoma (HCC) from metastatic carcinomas to the liver is often difficult, if not impossible, particularly in needle biopsy and fine-needle aspiration specimens. In an attempt to identify a specific immunohistochemical profile that would distinguish HCC from metastatic carcinomas, we studied 56 HCCs, 8 cholangiocarcinomas, and 24 metastatic adenocarcinomas with monoclonal antibodies to alpha-fetoprotein (AFP), keratin (AE1, AE3, and CAM5.2), Leu-M1, human milk fat globule (HMFG-2), tumor-associated glycoprotein-72(B72.3), epithelial specific membrane antigen (Ber-EP4), and BCA-225 (CU-18). Both monoclonal and polyclonal (mCEA and pCEA) antibodies to carcinoembryonic antigen also were used. Metastatic adenocarcinomas were often positive for CU-18(71%), Leu-M1 (75%), B72.3 (50%), HMFG-2 (67%), Ber-EP4(83%) and mCEA(71%). Using these antibodies, the frequency of positivity for HCC was 9%, 16%, 11%, 20%, 36%, and 11%, respectively. CU-18 was the only monoclonal antibody in which there was a significant difference in positive rates between HCC and metastatic adenocarcinomas. Most HCCs (71%) revealed a bile canalicular staining pattern with pCEA. Because this staining pattern was absent in metastatic carcinomas, pCEA appears to be useful in confirming a diagnosis of HCC. AE1, AE3 and CAM5.2 antibodies were not useful in distinguishing HCC from metastatic carcinomas. Each cholangiocarcinoma shared a staining profile similar to that of metastatic carcinomas.
authors.affiliation: Department of Pathology, Henry Ford Hospital, Detroit, Michigan 48202.
authors.forename: C K
authors.initials: CK
authors.lastname: Ma
authors.forename: R J
authors.initials: RJ
authors.lastname: Zarbo
authors.forename: H F
authors.initials: HF
authors.lastname: Frierson
authors.forename: M W
authors.initials: MW
authors.lastname: Lee
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000473:pathology* / Q000556:secondary*; D002759:Adenoma, Bile Duct / Q000737:chemistry / Q000473:pathology*; D000911:Antibodies, Monoclonal; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000737:chemistry / Q000473:pathology*; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis; D008113:Liver Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000556:secondary*; D008562:Membrane Glycoproteins / Q000032:analysis; D018396:Mucin-1; D012189:Retrospective Studies; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000911:Antibodies, Monoclonal; D015214:Antigens, Differentiation, Myelomonocytic; D002272:Carcinoembryonic Antigen; D008562:Membrane Glycoproteins; D018396:Mucin-1; D000509:alpha-Fetoproteins; D007633:Keratins