Hep Par 1 and selected antibodies in the immunohistological distinction of hepatocellular carcinoma from cholangiocarcinoma, combined tumours and metastatic carcinoma.
OBJECTIVE
To examine the usefulness of Hep Par 1 together with selected antibodies in the separation of hepatocellular carcinoma (HCC) from cholangiocarcinoma (CC), combined tumours (HCC-CC) and metastatic carcinoma.


RESULTS
Antibodies to Hep Par 1, CK19, CK20 and factor XIIIa were applied to 32 HCCs, 27 CCs, five HCC-CCs and 19 metastatic carcinomas from a variety of sites. Hep Par 1 produced distinctive granular staining of all benign hepatocytes and stained 30 HCCs in a heterogeneous manner, irrespective of the degree of differentiation. While labelling all cases of combined HCC-CC, the antibody also stained the mucus-secreting cells of four cases of pure CC. Anti-CK19 produced distinctive staining of bile ducts and CC but also decorated four HCCs and 10 metastatic tumours. Factor XIIIa was not found in normal, reactive or neoplastic hepatocytes. CK20 was found in some cases of HCC and CC and in all cases of metastatic carcinomas from the colon.


CONCLUSIONS
Hep Par 1 was a sensitive marker of hepatocytes but its variable staining in HCC may produce false negative results in small biopsies and it was occasionally found in CC. The highest diagnostic yield was obtained when anti-Hep Par 1, CK19 and CK20 were used in a panel. Factor XIIIa staining has no role in the diagnosis of liver cancers.
Leong
A S
AS
Department of Anatomical & Cellular Pathology, Chinese University of Hong Kong, Hong Kong.
Sormunen
R T
RT
Tsui
W M
WM
Liew
C T
CT
D000906:Antibodies; D000951:Antigens, Neoplasm / Q000276:immunology; D014408:Biomarkers, Tumor / Q000276:immunology; D006528:Carcinoma, Hepatocellular / Q000276:immunology*; D002454:Cell Differentiation; D018281:Cholangiocarcinoma / Q000276:immunology*; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D007381:Intermediate Filament Proteins / Q000276:immunology; D053554:Keratin-20; D007633:Keratins / Q000276:immunology; D008113:Liver Neoplasms / Q000276:immunology* / Q000556:secondary*; D009378:Neoplasms, Multiple Primary / Q000276:immunology*; D011503:Transglutaminases / Q000276:immunology
D000906:Antibodies; D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D007381:Intermediate Filament Proteins; C507499:KRT20 protein, human; D053554:Keratin-20; D007633:Keratins; D011503:Transglutaminases