The comparative analysis of immunohistochemical parameters of primary liver cancer and liver metastases of malignant tumors of solid, trabecular, tubular-glandular structure in puncture trephine biopsy
DOI:
https://doi.org/10.14739/2310-1237.2015.3.56113Keywords:
Hepatocellular Carcinoma, Cholangiocellular Carcinoma, Tumors Liver Metastases, ImmunohistochemistryAbstract
Aim. In puncture trephine biopsy of the liver differential immunohistochemical (IHC) parameters of hepatocellular carcinoma (HCC) in 30 patients, cholangiocellular cancer (CC) of the liver in 15 patients, and liver metastases of malignant tumors of solid, trabecular structure [melanoma (12), breast cancer (10), neuroendocrine tumors (12), prostate cancer (2)] and tubuloglandular structure [ductal carcinoma of the pancreas (12), adenocarcinoma of the stomach (10), colorectal cancer (17), RCC (6), cancer lung (4)] were studied.
Methods and results. It is established that melanoma metastases of solid-trabecular microstructure in the liver, as opposed to HCC, are characterized by expression of S100, HMB45, tyrosinase and lack of the expression of hepatocyte markers (HepPar-1, α-FTP). Liver metastases of neuroendocrine tumors of solid, trabecular microstructure have the IHC profile S100 + / ChG + / Syn + / CD56 +, to distinguish them from primary HCC and CC as well as liver metastases of other tumors. In view of the ultrasound and clinical-laboratory data of mammary (breast) cancer metastases were identified by CK7 + / CK20- / Er + / Mgl + immunophenotype, metastases of prostate cancer - by CK7- / CK20- / Andr + / PSA + immunophenotype. Liver metastases of adenocarcinoma of the stomach and colorectal cancers of tubular and glandular-acinar structure have the similar IHC expression profile of CK20, CDX2, CA 19-9, and CA 125 mucin, MUC2 and MUC5AC, the differential value has no CK7 expression in metastases of colorectal cancer and its presence in metastases of adenocarcinoma of the stomach.
Conclusions. For the differential diagnosis in trephine biopsy of the liver which have the similar IHC profile of metastases of ductal pancreatic cancer, gastric adenocarcinoma and colorectal cancer, additional clinical data and instrumental studies of patients (ultrasound, computed tomography, gastroscopy and colonoscopy) are necessary.
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