title: The application of markers (HSP70 GPC3 and GS) in liver biopsies is useful for detection of hepatocellular carcinoma.
abstract: OBJECTIVE
  Liver biopsy for hepatocellular carcinoma (HCC) detection is largely restricted to small hepatocellular lesions, which are often morphologically challenging, requiring careful distinction between dysplastic nodules (high-grade) and well-differentiated HCC.
  
  
  METHODS
  We investigated the diagnostic accuracy of a panel of markers (HSP70 GPC3 and GS), previously tested in resection specimens, in a series of liver biopsies of large regenerative nodules (n=13), low-grade dysplastic nodules (n=21), high-grade dysplastic nodules (n=50), very well-differentiated (VWD) (n=17), well-differentiated (WD-G1) (n=40) and G2-3 (n=35) HCC.
  
  
  RESULTS
  Almost all cases of large regenerative and low-grade dysplastic nodules did not stain while high-grade dysplastic nodules showed 1 marker (22%) but never 2 or 3. For HCC detection the overall accuracy of marker combination was 60.8% (3 markers) and 78.4% (2 markers) with 100% specificity. When restricted to VWD+WD-G1 HCC the accuracy was 57% (3 markers) and 72.9% (2 markers) with 100% specificity.
  
  
  CONCLUSIONS
  This panel proved useful to detect well-differentiated HCC in biopsy. Two immunoreactive markers (out of 3) are recommended as the most valuable diagnostic combination for HCC detection. The diagnostic accuracy of the panel could be improved using additional markers, as suggested by studies of expression profiling in other human models.
authors.affiliation: Department of Pathology, University of Milan School of Medicine & IRCCS Humanitas Clinical Institute, Via Manzoni 56, 20089 Rozzano, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Di Tommaso
authors.forename: Annarita
authors.initials: A
authors.lastname: Destro
authors.forename: Jae Yeon
authors.initials: JY
authors.lastname: Seok
authors.forename: Emanuela
authors.initials: E
authors.lastname: Balladore
authors.forename: Luigi
authors.initials: L
authors.lastname: Terracciano
authors.forename: Angelo
authors.initials: A
authors.lastname: Sangiovanni
authors.forename: Massimo
authors.initials: M
authors.lastname: Iavarone
authors.forename: Massimo
authors.initials: M
authors.lastname: Colombo
authors.forename: Ja June
authors.initials: JJ
authors.lastname: Jang
authors.forename: Eunsil
authors.initials: E
authors.lastname: Yu
authors.forename: So Young
authors.initials: SY
authors.lastname: Jin
authors.forename: Emanuela
authors.initials: E
authors.lastname: Morenghi
authors.forename: Young Nyun
authors.initials: YN
authors.lastname: Park
authors.forename: Massimo
authors.initials: M
authors.lastname: Roncalli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000201:enzymology / Q000473:pathology*; D005260:Female; D005974:Glutamate-Ammonia Ligase / Q000032:analysis*; D053673:Glypicans / Q000032:analysis*; D018840:HSP70 Heat-Shock Proteins / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000201:enzymology / Q000473:pathology*; D008297:Male; D008875:Middle Aged
chemical_list: D014408:Biomarkers, Tumor; C105937:GPC3 protein, human; D053673:Glypicans; D018840:HSP70 Heat-Shock Proteins; D005974:Glutamate-Ammonia Ligase