title: Differential diagnosis of malignant epithelial tumours in the liver: an immunohistochemical study on liver biopsy material.
abstract: BACKGROUND
  A variety of primary and secondary malignant tumours may present in the liver. In clinical practice the most commonly encountered hepatic tumours are primary hepatocellular carcinoma, metastatic carcinoma and primary cholangiocarcinoma, each with its separate prognostic and management implications. When these tumours are poorly differentiated and the biopsy size is limited to a needle core, the distinction can be extremely difficult.
  
  
  METHODS
  All liver tumours reported between 1994 and 2004 were examined. Slides from each case were tested separately with each of nine antibodies (HepPar1, CD10, MOC31, Villin, pCEA, mCEA, CK7, CK19, and CK20).
  
  
  RESULTS
  Liver biopsy tissue from 53 patients was examined in this retrospective study. The 53 liver biopsies were classified thus: hepatocellular carcinoma (n = 23); metastatic adenocarcinoma (n = 15); cholangiocarcinoma (n = 5); metastatic small cell carcinoma (n = 7); liver cell dysplasia (n = 1); carcinoid (n = 1); and unclassified (n = 1). Sensitivity and specificity values for different antibodies in relation to their positive staining of specific tumours was as follows: HepPar1 for HCC-81.8% and 100%; MOC31 for MA-73.3% and 92.1%; MOC31 for MA and CC as a combined group-65% and 100%; pCEA (canalicular) for HCC-82.6% and 83.3%; mCEA for MA-93.3% and 75.6%; CK7 for CC-100% and 68%; CK19 for MA and CC as a combined group-90% and 86.3%.
  
  
  CONCLUSIONS
  An antibody panel consisting of HepPar1, pCEA, CK19 and CK7 together with either MOC31 or mCEA is recommended for use in the differential diagnosis of HCC, MA and CC.
authors.affiliation: Department of Pathology, Arabian Gulf University, Bahrain.
authors.forename: Najla
authors.initials: N
authors.lastname: Al-Muhannadi
authors.forename: Naseem
authors.initials: N
authors.lastname: Ansari
authors.forename: Urmil
authors.initials: U
authors.lastname: Brahmi
authors.forename: Ali Abdel
authors.initials: AA
authors.lastname: Satir
mesh_terms: D000230:Adenocarcinoma / Q000737:chemistry / Q000175:diagnosis* / Q000556:secondary; D001445:Bahrain; D001650:Bile Duct Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000737:chemistry* / Q000473:pathology; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D018281:Cholangiocarcinoma / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor