title: Diagnostic role of glypican 3 and CD34 for differentiating hepatocellular carcinoma from nonmalignant hepatocellular lesions.
abstract: Well-differentiated hepatocellular carcinoma (HCC) may be difficult to distinguish from a benign lesion. Glypican 3 (GPC-3) is an oncofetal protein, which has been demonstrated to be up-regulated in HCC. The aim of this study is to evaluate the diagnostic role of combined GPC-3 and CD34 immunoassaying in the distinction between HCC and benign hepatic mimickers. This study was performed on 100 cases of formalin-fixed, paraffin-embedded cases of hepatic focal lesions obtained from the files of pathology laboratory of our university from 2009 to 2012. The following groups were studied: group A (n = 60) (hepatocellular malignant lesions) and group B (n = 40) (Hepatocellular nonmalignant lesions). All cases were stained with GPC-3 and CD34. Sensitivity, specificity, and positive and negative predictive values were calculated for both antibodies. Glypican 3 and complete CD34 staining pattern expression in group A was significantly higher than in group B. The results of costaining showed that, in HCCs, almost all the GPC-3-positive cases had a complete CD34 staining pattern, whereas in the 40 hepatocellular nonmalignant lesions, none stained up with the 2 markers. Therefore, although the sensitivity declined (82%), the specificity and positive predictive value (PPV) of costaining reached 100% and were greater than that observed for single staining with GPC-3 (specificity, 92.5%; PPV, 94.3%) or CD34 (specificity, 97.5%; PPV, 98.3%). Our data demonstrate that GPC-3 and CD34 costaining has better diagnostic value for differentiating HCC from nonmalignant hepatocellular lesions than does single staining.
authors.affiliation: Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Eman Tawfik
authors.initials: ET
authors.lastname: Enan
authors.forename: Amira Kamal
authors.initials: AK
authors.lastname: El-Hawary
authors.forename: Dina Abd El-Aziz
authors.initials: DA
authors.lastname: El-Tantawy
authors.forename: Maha Mohamed
authors.initials: MM
authors.lastname: Abu-Hashim
authors.forename: Nagwa Mokhtar
authors.initials: NM
authors.lastname: Helal
mesh_terms: D018952:Antigens, CD34 / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D053673:Glypicans / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008107:Liver Diseases / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D016612:Paraffin Embedding; D011230:Precancerous Conditions; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D018952:Antigens, CD34; D014408:Biomarkers, Tumor; C105937:GPC3 protein, human; D053673:Glypicans
keywords: 3; CD34; Combined; Glypican; Hepatocellular carcinoma