title: Arginase-1 is a more sensitive marker of hepatic differentiation than HepPar-1 and glypican-3 in fine-needle aspiration biopsies.
abstract: BACKGROUND
  Distinguishing hepatocellular carcinoma (HCC) from adenocarcinoma in fine-needle aspiration biopsies (FNAB) is often diagnostically challenging. Arginase-1 was recently described as a marker of hepatic differentiation in surgical resection specimens. We compared the expression of arginase-1, HepPar-1, and glypican-3 in FNAB of HCC and adenocarcinoma involving the liver.
  
  
  METHODS
  Ninety-eight FNABs including 37 primary or metastatic HCCs (30 well or moderately differentiated and 7 poorly differentiated) and 61 adenocarcinomas involving the liver were evaluated for immunohistochemical expression of arginase-1, HepPar-1, and glypican-3 using formalin-fixed paraffin-embedded cell block material.
  
  
  RESULTS
  Arginase-1 was more sensitive (81%) than HepPar-1 (70%) or glypican-3 (54%) for HCC. Arginase-1 more often demonstrated diffuse staining, defined as reactivity in >50% of the tumor, in HCC (21 of 37; 57%) compared with HepPar-1 (15 of 37; 41%) and glypican-3 (12 of 37; 32%). Of the 7 poorly differentiated HCCs, 3 (43%) were immunoreactive for both arginase-1 and glypican-3, whereas only 1 (14%) demonstrated HepPar-1 staining. Arginase-1 expression was identified in adenocarcinomas of pancreatic, colorectal, and breast origin, and reactivity was diffuse in 2 pancreatic adenocarcinomas (2 of 15; 13%).
  
  
  CONCLUSIONS
  Arginase-1 is a more sensitive marker of hepatic differentiation than either HepPar-1 or glypican-3 in FNAB. In addition, arginase-1 exhibits more diffuse staining in HCC than either HepPar-1 or glypican-3, making interpretation easier in limited FNAB samples. Arginase-1 is not entirely specific for hepatic differentiation, as immunoreactivity can be identified in adenocarcinomas, particularly of pancreatic origin.
authors.affiliation: Department of Pathology, Stanford University, Stanford, California 94305, USA.
authors.forename: Mika
authors.initials: M
authors.lastname: Fujiwara
authors.forename: Shirley
authors.initials: S
authors.lastname: Kwok
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Yano
authors.forename: Reetesh K
authors.initials: RK
authors.lastname: Pai
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology; D001119:Arginase / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000378:metabolism* / Q000556:secondary; D002454:Cell Differentiation; D015179:Colorectal Neoplasms / Q000378:metabolism* / Q000473:pathology; D003581:Cytodiagnosis; D005260:Female; D053673:Glypicans / Q000378:metabolism*; D006801:Humans; D007124:Immunoenzyme Techniques; D008113:Liver Neoplasms / Q000378:metabolism* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000378:metabolism* / Q000473:pathology; D011379:Prognosis; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D053673:Glypicans; D001119:Arginase