The application of markers (HSP70 GPC3 and GS) in liver biopsies is useful for detection of hepatocellular carcinoma.
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.
Di Tommaso
Luca
L
Department of Pathology, University of Milan School of Medicine & IRCCS Humanitas Clinical Institute, Via Manzoni 56, 20089 Rozzano, Milan, Italy.
Destro
Annarita
A
Seok
Jae Yeon
JY
Balladore
Emanuela
E
Terracciano
Luigi
L
Sangiovanni
Angelo
A
Iavarone
Massimo
M
Colombo
Massimo
M
Jang
Ja June
JJ
Yu
Eunsil
E
Jin
So Young
SY
Morenghi
Emanuela
E
Park
Young Nyun
YN
Roncalli
Massimo
M
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
D014408:Biomarkers, Tumor; C105937:GPC3 protein, human; D053673:Glypicans; D018840:HSP70 Heat-Shock Proteins; D005974:Glutamate-Ammonia Ligase