Hepatic progenitor cells in liver cancers from Asian children.
OBJECTIVE
Hepatoblastoma (HB) and hepatocellular carcinoma (HCC) are the two most common primary malignant liver tumours in children. Hepatic progenitor cells have been described and can be stained with K19, EpCAM and CD117. We investigated the morphology and staining patterns of primary liver tumours in Asian children.


METHODS
Four pathologists studied slides from 39 paediatric patients from Vietnam and Korea aged 8 months to 16 years. We performed immunohistochemical stains for K19, EpCAM and CD117, and polymerase chain reaction for tissue hepatitis B virus (HBV) DNA and hepatitis C virus (HCV) RNA.


RESULTS
There was agreement on the diagnosis of 24 cases of HCC and 10 cases of HB (one recurrent case). The diagnosis was split for six cases (HCC/HB). All 20 cases of HCC tested were HBV DNA+ and HCV RNA-. All nine cases of HB tested were HBV DNA-, while one was HCV RNA+. Of four HCC/HB cases tested, three were HBV DNA+ and all were HCV RNA-. By immunohistochemistry, 8/24 (33%) cases of HCC were K19+ and 18/24 (75%) were EpCAM+, 5/10 (50%) cases of HB were K19+ and 7/10 (70%) were EpCAM+ and 3/6 (50%) cases of HCC/HB were K19+ and 5/6 (83%) were EpCAM+. CD117 was negative in all 38 cases tested. Paediatric HCC has a morphology different from adult HCC, sometimes resembling HB, and a larger proportion of paediatric tumours have progenitor cell features.


CONCLUSIONS
HB and HCC in children may represent malignant transformation at an early stage in the cellular lineage and often arise from hepatic progenitor cells.
Department of Pathology, The Mount Sinai Medical Center, New York, NY 10029, USA. stephen.ward@mssm.edu
Stephen C
SC
Ward
Swan N
SN
Thung
Kiat Hon
KH
Lim
Tung Thanh
TT
Tran
Thi Khang Bui
TK
Hong
Phuc Le
PL
Hoang
Ja June
JJ
Jang
Young Nyun
YN
Park
Kenji
K
Abe
D000293:Adolescent; D000951:Antigens, Neoplasm / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D015815:Cell Adhesion Molecules / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D000071858:Epithelial Cell Adhesion Molecule; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D018197:Hepatoblastoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D022781:Hepatocytes / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D053539:Keratin-19 / Q000378:metabolism; D008113:Liver Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008297:Male; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism; D012367:RNA, Viral / Q000032:analysis; D015203:Reproducibility of Results; D013234:Stem Cells / Q000378:metabolism / Q000473:pathology*
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015815:Cell Adhesion Molecules; D004279:DNA, Viral; D000071858:Epithelial Cell Adhesion Molecule; D053539:Keratin-19; D012367:RNA, Viral; D019009:Proto-Oncogene Proteins c-kit