The significance of galectin-3 immunohistochemistry, clinical characteristics and liver imaging in differentiating intrahepatic cholangiocarcinoma from adenocarcinoma liver metastasis.
OBJECTIVE
To identify differences of Galectin-3 (Gal-3) immunostaining, clinical profiles, and images in patients with intrahepatic cholangiocarcinoma (IHC) and adenocarcinoma liver metastasis, and be able to recognize these parameters as diagnostic tools for differentiating these two diseases.


METHODS
Histological slides from patients with IHC and adenocarcinoma liver metastasis were reviewed Immunohistochemical staining for Gal-3, Cytokeratin-7 (CK-7), and Cytokeratin-20 (CK-20) was performed and the results categorized. Moreover clinical characteristics and liver images of the patients were reviewed.


RESULTS
Eighty-two patients were evaluated, 31 IHC and 51 adenocarcinoma liver metastasis. Patients who strongly expressed Gal-3 were positive for CK-7 and negative for CK-20. Finding showed that 86% of them were IHC whereas only 14% were in adenocarcinoma liver metastasis. All patients with liver images showing a single lesion, located at central site, and having intrahepatic duct dilatation were IHC. On the other hand, 77% of patients with liver imaging showing multiple liver masses, located at peripheral site and having no intrahepatic duct dilatation were adenocarcinoma liver metastasis while only 23% were in IHC.


CONCLUSIONS
Adding Gal-3 to CK-7 and CK-20 immunohistochemistry has benefits to differentiate IHC from adenocarcinoma liver metastasis. Furthermore, liver imaging profiles also give benefits for differentiating between these two diseases.
Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. dearunee@medicine.psu.ac.th
Arunee
A
Dechaphunkul
Samornmas
S
Kanngurn
Chavaboon
C
Dechsukhum
Pramot
P
Tanutit
Uthai
U
Khow-Ean
Patrapim
P
Sunpaweravong
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000556:secondary; D000328:Adult; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000378:metabolism / Q000473:pathology; D014408:Biomarkers, Tumor / Q000378:metabolism; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D005260:Female; D037502:Galectin 3 / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D053554:Keratin-20 / Q000378:metabolism; D053552:Keratin-7 / Q000378:metabolism; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D014408:Biomarkers, Tumor; D037502:Galectin 3; D053554:Keratin-20; D053552:Keratin-7