Diagnostic utility of Glut-1 and CA 15-3 in discriminating adenocarcinoma from hepatocellular carcinoma in liver tumors biopsied by fine-needle aspiration.
BACKGROUND
Diagnosing liver tumors can be difficult in the setting of a poorly differentiated tumor or tumors with no known prior malignancy. Frequently, alpha-fetoprotein, carcinoembryonic antigen, factor VIII, and mucicarmine have been employed to distinguish hepatocellular carcinoma (HCC) from adenocarcinoma. However, these stains have their limitations. CA 15-3 and Glut-1 are expressed in a variety of carcinomas. To the authors' knowledge, their expression in HCC has not been studied extensively. The authors examined the clinical utility of CA 15-3 and Glut-1 in the setting of fine-needle aspiration biopsy samples from the liver.


METHODS
Thirty-five cases of HCC and 59 cases of tumors metastatic to the liver were studied. These cases previously were studied with the hepatocyte paraffin-1 antibody. Each case was stained with CA 15-3 and Glut-1 using the avidin-biotin complex method. Each case was evaluated in a blinded fashion for membranous staining that was stronger than cytoplasmic or background staining. The diagnoses were unblinded and staining patterns were compared.


RESULTS
CA 15-3 stained 43 of 59 metastatic carcinoma samples and 3 of 35 HCC samples. Glut-1 stained 34 of 59 metastases and 2 of 35 HCCs. Together, the 2 immunostains stained 51 of 59 metastases and 5 of 35 HCCs. Diagnostic accuracy was improved by adding hepatocyte paraffin-1 to the staining panel.


CONCLUSIONS
CA 15-3 and Glut-1, especially in conjunction with hepatocyte paraffin-1, appear to be helpful in discriminating HCC from other carcinomas.
Zimmerman
Robert L
RL
Department of Pathology W-547, Presbyterian Medical Center, Philadelphia, Pennsylvania 19104, USA. Robertz@mail.med.upenn.edu
Burke
Melissa
M
Young
Nancy A
NA
Solomides
Charalambos C
CC
Bibbo
Marluce
M
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D051272:Glucose Transporter Type 1; D022781:Hepatocytes; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D009004:Monosaccharide Transport Proteins / Q000032:analysis*; D018396:Mucin-1 / Q000032:analysis*; D012680:Sensitivity and Specificity
D051272:Glucose Transporter Type 1; D009004:Monosaccharide Transport Proteins; D018396:Mucin-1; C495677:SLC2A1 protein, human