title: A novel diagnostic marker, p28GANK distinguishes hepatocellular carcinoma from potential mimics.
abstract: OBJECTIVE
  To investigate the sensitivity, specificity, and spatial distribution of the product of p28 gene (p28(GANK) protein) in human hepatocellular carcinoma (HCC) and nonhepatocellular carcinomas in relation to immunostaining with Cytokeratin 18 (CK18), alpha-fetoprotein (AFP), and Hepatocyte paraffin 1 (HepPar1).
  
  
  METHODS
  In this retrospective study, formalin-fixed paraffin-embedded tissues from 24 HCCs, five intrahepatic cholangiocarcinomas (ICC), five combined hepatocellular cholangiocarcinomas (C-HCC-CC) and mine metastatic hepatic carcinomas (MHC) were immunostained for p28(GANK) as well as CK18, AFP and HepPar1. Only cases with more intensified staining in carcinoma contrast to the adjacent liver tissues were accepted as positive.
  
  
  RESULTS
  In HCC, p28(GANK) was expressed restrictively in hepatocytes of both para-lesion and carcinoma liver tissues, while absent in the bile duct epithelial cells, Kupffer cells, and other interstitial cells. The positive staining of p28(GANK) was noted in 16 (66.7%) specimens of HCC and three (60.0%) specimens of C-HCC-CC, and no specific lesion staining was found in all tested specimens of ICC and MHC. Sensitivity and specificity for hepatocyte-originated carcinoma were, respectively, 65.5% and 100% for p28(GANK), 79.3% and 85.2% for CK18, 20.7% and 100% for AFP, 79.3% and 92.0% for HepPar1.
  
  
  CONCLUSIONS
  The hepatocytic staining for p28(GANK) is clearly useful in differentiating hepatocyte-originated carcinoma from non-HCC. p28(GANK) may be used as an ancillary marker for the diagnosis of HCC.
authors.affiliation: International Co-operation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Institute, Second Military Medical University, 225 Changhai Road, 200438 Shanghai, P.R. China.
authors.forename: Xiaoyong
authors.initials: X
authors.lastname: Fu
authors.forename: Lu
authors.initials: L
authors.lastname: Tan
authors.forename: Shuqin
authors.initials: S
authors.lastname: Liu
authors.forename: Honghai
authors.initials: H
authors.lastname: Li
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.forename: Jianmin
authors.initials: J
authors.lastname: Qin
authors.forename: Mengchao
authors.initials: M
authors.lastname: Wu
authors.forename: Hongyang
authors.initials: H
authors.lastname: Wang
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000737:chemistry* / Q000175:diagnosis* / Q000556:secondary; D018281:Cholangiocarcinoma / Q000737:chemistry / Q000175:diagnosis; D003937:Diagnosis, Differential; D022781:Hepatocytes / Q000737:chemistry; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis; D008113:Liver Neoplasms / Q000737:chemistry* / Q000175:diagnosis* / Q000556:secondary; D015513:Oncogene Proteins / Q000032:analysis*; D010232:Paraffin / Q000032:analysis; D046988:Proteasome Endopeptidase Complex; D011518:Proto-Oncogene Proteins; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D015513:Oncogene Proteins; C403591:PSMD10 protein, human; D011518:Proto-Oncogene Proteins; D000509:alpha-Fetoproteins; D007633:Keratins; D010232:Paraffin; D046988:Proteasome Endopeptidase Complex