[Immunohistochemical spectrum in the detection and differentiation of intrahepatic neoplasms].
OBJECTIVE
To scrutinize the immunohistochemical spectrum to differentiate hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICC) and metastatic adenocarcinoma (MAC) in the liver.


METHODS
Seven antibodies including AFP, Hep Par 1, CK18, CK19, CA19-9, CD34 and pCEA were immunohistochemically stained in resected specimens of 300 HCC, 35 ICC and 30 MAC. The specificity and sensitivity of the antibodies were evaluated by comprehensive capability score (CCS), with only those with CCS > or = 8 considered as having highly diagnostic value.


RESULTS
Antibodies CCS > or = 8 were observed as Hep Par 1 and CD34 in HCC, and CK19 in ICC, but none in MAC. For HCC, CCS of Hep Par 1 was higher than that of AFP (9 vs. 7) with 83.7% in sensitivity and 96.7% in specificity.


CONCLUSIONS
For HCC, Hep Par 1 and CD34 can be used as the first line antibodies, AFP and pCEA as the second line ones. CK19 is the first line antibody for ICC, and CA19-9 as the second. Hep Par 1, CD34 and CK19 are definitely helpful for the routine immunohistochemical stain to differentiate HCC from ICC and MAC.
Cong
Wenming
W
Department of Pathology, Oriental Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
Tan
Lu
L
Zhang
Shuhui
S
Xian
Zhihong
Z
Wu
Weiqing
W
Pan
Jing
J
Zhang
Xiuzhong
X
D000230:Adenocarcinoma / Q000737:chemistry; D000906:Antibodies / Q000276:immunology; D006528:Carcinoma, Hepatocellular / Q000737:chemistry*; D018281:Cholangiocarcinoma / Q000737:chemistry*; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000737:chemistry*; D014407:Tumor Cells, Cultured
D000906:Antibodies