- 作者：Luca Di Tommaso ; Annarita Destro ; Jae Yeon Seok ; Emanuela Balladore ; Luigi Terracciano ; Angelo Sangiovanni ; Massimo Iavarone ; Massimo Colombo ; Ja June Jang ; Eunsil Yu ; So Young Jin ; Emanuela Morenghi
- 关键词：Markers ; Hepatocellular carcinoma ; Dysplastic nodules ; Differential diagnosis ; Liver biopsy
- 刊名：Journal of Hepatology
- 出版年：2009
- 出版时间：April 2009
- 年：2009
- 卷：50
- 期：4
- 页码：746-754
- 全文大小：961 K
Background/Aims
Liver biopsy for hepatocellular carcinoma (HCC) detection is largely restricted to small hepatocellular lesions, which are often morphologically challenging, requiring careful distinction between dysplastic nodules (high-grade) and well-differentiated HCC.Methods
We investigated the diagnostic accuracy of a panel of markers (HSP70 GPC3 and GS), previously tested in resection specimens, in a series of liver biopsies of large regenerative nodules (n = 13), low-grade dysplastic nodules (n = 21), high-grade dysplastic nodules (n = 50), very well-differentiated (VWD) (n = 17), well-differentiated (WD-G1) (n = 40) and G2-3 (n = 35) HCC.
Results
Almost all cases of large regenerative and low-grade dysplastic nodules did not stain while high-grade dysplastic nodules showed 1 marker (22 % ) but never 2 or 3. For HCC detection the overall accuracy of marker combination was 60.8 % (3 markers) and 78.4 % (2 markers) with 100 % specificity. When restricted to VWD + WD-G1 HCC the accuracy was 57 % (3 markers) and 72.9 % (2 markers) with 100 % specificity.
Conclusions
This panel proved useful to detect well-differentiated HCC in biopsy. Two immunoreactive markers (out of 3) are recommended as the most valuable diagnostic combination for HCC detection. The diagnostic accuracy of the panel could be improved using additional markers, as suggested by studies of expression profiling in other human models.