title: Biliary phenotype of hepatocellular carcinoma after preoperative transcatheter arterial chemoembolization.
abstract: OBJECTIVE
  Transcatheter arterial chemoembolization (TACE) is now the mainstay of treatment for non-curative hepatocellular carcinoma (HCC), and hoped to have chemotherapeutic and ischemic effects; however, the histopathological changes of HCC caused by TACE have not been sufficiently discussed so far. We aimed to assess the morphological and immunohistochemical features of HCC treated with TACE by immunostaining cytokeratin (CK) 7, CK14, CK19 and vimentin, and to correlate these data with observed clinicopathological characteristics.
  
  
  METHODS
  Eighty cases of surgically resected HCC with preoperative TACE and 146 cases of HCC resected without TACE as a control were analyzed.
  
  
  RESULTS
  The incidences of intrahepatic metastasis, poorly differentiated histology, multinucleated giant cells, mitotic figures and cytoplasmic inclusion bodies in the TACE group were significantly higher than those in the non-TACE group. The TACE group showed reactivity for CK7 in 56.3% (45/80) of patients, CK14 in 12.5% (10/80), CK19 in 23.8% (19/80) and vimentin in 6.3% (5/80) of patients. CK19 expression in the TACE group was significantly higher than in the non-TACE group (P = 0.0423). There was no correlation between immunoreactivity and the number of times TACE was carried out, but the expression of CK19 and vimentin in the massive necrotic group was higher than that in the mild necrotic group (P = 0.0197, P = 0.0229, respectively). Only TACE was an independent determinant of CK19 expression in all cases by multivariate analysis.
  
  
  CONCLUSIONS
  These results suggest that preoperative TACE may have an impact on the biliary phenotype of HCC. Some post-therapeutic HCC patients might develop HCC with a biliary phenotype indicating more aggressive malignancies.
authors.affiliation: Departments of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Yunosuke
authors.initials: Y
authors.lastname: Nishihara
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aishima
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Kuroda
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Iguchi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Taguchi
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Asayama
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Naoko
authors.initials: N
authors.lastname: Kinukawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
authors.forename: Masazumi
authors.initials: M
authors.lastname: Tsuneyoshi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract / Q000737:chemistry / Q000473:pathology*; D006528:Carcinoma, Hepatocellular / Q000737:chemistry / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D016022:Case-Control Studies; D002454:Cell Differentiation; D049109:Cell Proliferation; D016461:Chemoembolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007150:Immunohistochemistry; D053547:Keratin-14 / Q000032:analysis; D053539:Keratin-19 / Q000032:analysis; D053552:Keratin-7 / Q000032:analysis; D008113:Liver Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D020360:Neoadjuvant Therapy; D010641:Phenotype; D016896:Treatment Outcome; D014746:Vimentin / Q000032:analysis
chemical_list: C507540:KRT14 protein, human; C507497:KRT7 protein, human; D053547:Keratin-14; D053539:Keratin-19; D053552:Keratin-7; D014746:Vimentin