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

Authors

DOI:

https://doi.org/10.14739/2310-1237.2015.3.56113

Keywords:

Hepatocellular Carcinoma, Cholangiocellular Carcinoma, Tumors Liver Metastases, Immunohistochemistry

Abstract

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.

References

Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., et al. (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 136(5), E359- E386. doi: 10.1002/ijc.29210.

Sempoux, C., Jibara, G., Ward, S. C., Fan, C., Qin, L., Roayaie, S. et al. (2011) Intrahepatic cholangiocarcinoma: new insights in pathology. Seminars in Liver Disease, 31(1), 49–60. doi: 10.1055/s-0031-1272839.

Venook, A. P., Papandreou, C., Furuse, J., & de Guevara, L. L. (2010) The incidence and epidemiology of hepatocellular carcinoma: a global and regional perspective. Oncologist, 15, 5–13. doi: 10.1634/theoncologist.2010-S4-05.

Colombo, M., & Sangiovanni, A. (2015) Treatment of hepatocellular carcinoma: beyond international guidelines. Liver International, 35(1), 129–138. doi: 10.1111/liv.12713.

Joo, I., Kim, H., & Lee, J. M. (2015) Cancer Stem Cells in Primary Liver Cancers: Pathological Concepts and Imaging Findings. Korean J Radiol., 16(1), 50–68. doi: 10.3348/kjr.2015.16.1.50.

Schlageter, M., Terracciano, L. M., D’Angelo, S., & Sorrentino, P. (2014) Histopathology of hepatocellular carcinoma. World J Gastroenterol, 20(43), 15955–15964. doi: 10.3748/wjg.v20.i43.15955.

Stainer, P. E., & Hagginson, J. (1959) Cholangiolocellular carcinoma of the liver. Cancer, 12, 753–759.

Guedj, N., Bedossa, P., & Paradis, V. (2010) Anatomopathologie des cholangiocarcinomes. Ann Pathol., 30(6), 455–463. doi: 10.1016/j.annpat.2010.10.004

Nakanuma, Y., & Kakuda, Y. (2015) Pathologic classification of cholangiocarcinoma: New concepts. Best Pract Res Clin Gastroenterol, 29(2), 277–293. doi: 10.1016/j.bpg.2015.02.006.

Rizvi, S., & Gores, G. J. (2013) Pathogenesis, Diagnosis, and Management of Cholangiocarcinoma. Gastroenterology, 145(6), 1215–1229. doi: 10.1053/j.gastro.2013.10.013.

McKenna, B., & Bihlmeyer, Sh. (2010) Pathology of hepatocellular carcinoma, cholangiocarcinoma and combined hepatocellular-cholangiocarcinoma. Primary Carcinomas of the Liver. J.E. Adviser (Ed), (P. 16–32). Husband: Cambridge University Press.

Pickren, J. W., Tsukada, Y., & Lane, W. W. (1982) Liver metastasis: analysis of autopsy data. Liver Metastasis. L. Weiss, H.A. Gilbert (Eds), (P. 2–18). GK Hall: Boston.

Graig, J. R., Peters, R. L., Edmondson, H. A. (1989) Tumors of the Liver and Intrahepatic Bile Ducts, (Vol 26). Washington, DC: AFIP.

Goodman, Z. D. (2007) Neoplasms of the liver. Modern Pathology, 20, S49–S60. doi:10.1038/modpathol.3800682.

Kasper, H. U., Drebber, U., Dries, V., & Dienes, H. P. (2005) Liver metastases: incidence and histogenesis. Z. Gastroenterol, 43(10), 1149–1157.

Tuffakha, M. S. A., Gichka, S. G., & Guski, G. L. (2013) Immunogistokhimicheskaya diagnostika opukholej [Immunohistochemical diagnosis of tumors]. Kyiv: Intermed. [in Ukrainian].

Shafizadeh, N., & Kakar, S. (2011) Diagnosis of well-differentiated hepatocellular lesions: role of immunohistochemistry and other ancillary techniques. Adv Anat Pathol., 18(6), 438–445. doi: 10.1097/PAP.0b013e318234abb4.

Tumanskij, V. A., & Zubko, M. D. (2014) Gepatocellyulyarnaya karcinoma: osobennosti mikrostruktury i ekspressii HepPar-1, alfa-fetoproteina, tsitokeratinov 7 i 20 [Hepatocellular carcinoma: microstructure features and expression HepPar-1, alpha-fetoprotein, cytokeratin 7 and 20]. Patolohiia, 30, 45–50. [in Ukrainian].

Ferrel, L. L., & Kаkаr, S. (2013) Tumors of the Liver, Biliary Tree and Gallblader. Diagnostic Histopathology of Tumors. Ch.D.M. Fletcher (Ed.), (Vol. 1), (P. 477–530). Philadelphia.

Shibuya, M., Kondo, F., Sano, K., Takada, T., & Asano, T. (2011) Immunohistochemical study of hepatocyte, cholangiocyte and stem cell markers of hepatocellular carcinoma. J Hepato-Biliary-Pancrc Science., 18, 537–543. doi: 10.1007/s00534-010-0365-2.

Lugli, A., Tornillo, L., Mirlacher, M., Bundi, M., Sauter, G., & Terracciano, L. M. (2004) Hepatocyte paraffin 1 expression in human normal and neoplastic tissues: tissue microarray analysis on 3,940 tissue samples. Am J Clin Pathol., 122, 721–727. doi: 10.1309/KC09-YTF2-M4DL-UYQ6.

Koehne de Gonzalez, A. K., Salomao, M. A., & Lagana, S. M. (2015) Current concepts in the immunohistochemical evaluation of liver tumors. World J Hepatol, 7(10), 1403–1411. doi: 10.4254/wjh.v7.i10.1403.

Kakar, S., Muir, T., Murphy, L. M., Lloyd, R.V., & Burgart, L. J. (2003) Immunoreactivity of HepPar-1 in hepatic and extrahepatic tumors and its correlation with albumin in situ hybridization in hepatocellular carcinoma. Am J Clin Pathol., 119, 361–366. doi: 10.1309/8L872RPHEJRKF5JJ.

International Consensus Group for Hepatocellular NeoplasiaThe International Consensus Group for Hepatocellular Neoplasia. (2009) The International Consensus Group for Hepatocellular Neoplasia. Pathologic diagnosis of early hepatocellular carcinoma: a report of the international consensus group for hepatocellular neoplasia. Hepatology, 49, 658–664. . doi: 10.1002/hep.22709.

Mounajjed, T., Zhang, L., & Wu, T. T. (2013) Glypican-3 expression in gastrointestinal and pancreatic epithelial neoplasms. Hum Pathol, 44, 542–550. doi: 10.1016/j.humpath.2012.06.016.

Karabork, A., Kaygusuz, G., & Ekinci, C. (2010) The best immunohistochemical panel for differentiating hepatocellular carcinoma from metastatic adenocarcinoma. Pathol Res Pract., 206(8), 572–577. doi: 10.1016/j.prp.2010.03.004.

Mishra, M., Morgan, V., Hamati, A. K., & Al-Abbadi, M. (2012) Carcinoma of unknown primary: check the liver... thanks to TTF-1. Tenn Med., 105(1), 35–36.

Strumfa, I., Vilmanis, J. Vanags A. et al. (2012) Primary and Metastatic Tumours of the Liver: Expanding Scope of Morphological and Immunohistochemical Details in the Biopsy. Liver biopsy – indications, procedures, results. Nobumi Tagaya (Ed.), (P. 115–159). Rijeka.

Gusarev, S. A. (2006) Patologoanatomicheskaya kharakteristika pervichnogo i metastaticheskogo raka pecheni (Avtoref. dis…kand. med. nauk). [Pathologic characteristics of primary and metastatic liver cancer] (Extended abstract of candidate’s thesis). Moscow. [in Russian].

Durnez, A., Verslype, C., Nevens, F., Fevery, J., Aerts, R., Pirenne, J., et al. (2006) The clinicopathological and prognostic relevance of cytokeratin 7 and 19 expression in hepatocellular carcinoma. A possible progenitor cell origin. Histopathology, 49, 138–151.

Wee, A. (2006) Diagnostic utility of immunohistochemistry in hepatocellular carcinoma, its variants and their mimics. Appl Immunohistochem Mol Morphol., 14(3), 266–272. doi: 10.1097/00129039-200609000-00003.

Tumanskiy, V. A., & Zubko, M. D. (2014) Characteristic of expression levels of HepPar-1, alpha-fetoprotein, cytokeratin 7 and 20 by cells of cholangiocellular cancer in trephine biopsy of the liver. Zaporozhskij medicinskij zhurnal, 5(86), 55– 58.

Ishak, K., Goodman, Z., Stocker, J. (Eds.) (2001) Tumors of the Liver and Intrahepatic Bile Ducts, (Vol. 31). Washington, DC: AFIP.

Basturk, О., Farris, III А.В., & Adsay, N. V. (2010) Immunohistology of the Pancreas, Biliary Tract and Liver. Diagnostic immunohistochemistry: theranostic and genomic applications. D.J. Dabbs (Еd.), (P. 541–592). Philadelphia: Saunders/Elsevier.

Orchard, G. (2002) Evaluation of melanocytic neoplasms: application of a pan-melanoma antibody cocktail. Br J Biomed Sci., 59, 196–202.

Miller, R. T. (2011) Immunohistochemistry in the diagnosis of metastatic carcinoma of unknown primary origin (American Academy of Oral and Maxillofacial Pathology Annual Meeting). San Juan, Puerto Rico.

Nash, J. W., Morrison, C., & Frankel, W. L. (2003) The utility of estrogen receptor and progesterone receptor immunohistochemistry in the distinction of metastatic breast carcinoma from other tumors in the liver. Arch Pathol Lab Med., 127(12), 1591–1595. doi: 10.1043/1543-2165(2003)127<1591:TUOERA>2.0.CO;2.

Centeno, B. A. (2006) Pathology of Liver Metastases. Cancer Control., 13(1), 13– 26.

Tumanskiy, V. A., & Zubko, M. D. (2015) Sravnitelnaya immunogistokhimicheskaya kharakteristika gepatocellyulyarnogo, kholangiocellyulyarnogo raka i metastazov v pechen' raka podzheludochnoj zhelezy v punkcionnykh trepanobioptatah pecheni [Comparative immunohistochemical characteristics of hepatocellular, cholangiocellular cancer and liver metastases of pancreatic cancer in the bone marrow trephine biopsy of the liver puncture]. Zaporozhskij medicinskij zhurnal, 5(92), 54–61.

Dennis, J. L., Hvidsten, T. R., Wit, E.C., Komorowski, J., Bell, A. K., Downie, I. et al. (2005) Markers of adenocarcinoma characteristic of the site of origin: development of a diagnostic algorithm. Clin Cancer Res, 11(10), 3766–3772. doi: 10.1158/1078-0432.CCR-04-2236.

Makoto, Osanai. (2005) Expression of Carbohydrate Antigens in Pancreatic Cancer. Handbook of Immunohistochemistry and in situ Hybridization of Human Carcinomas, (Vol. 3), (P. 341–350).

Sawan, A. S. (2009) The Diagnostic Value of Immunohistochemistry in the Diagnosis of Primary and Secondary Hepatic Carcinomas. JKAU: Med. Sci., 16(4), 37–48.

Ischenko, R. V. (2012) Profilaktyka ta likuvannia metastatychnoho urazhennia pechinky pry kolorektalnomu raku (Avtoref. dis… dokt. med. nauk) [Prevention and Treatment of metastatic liver lesions in colorectal cancer Dr. med. sci. diss.]. Donetsk. [in Ukrainian].

How to Cite

1.
Tumanskiy VA, Zubko MD, Maksimenko VG. 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. Pathologia [Internet]. 2015Dec.18 [cited 2024Apr.16];(3). Available from: http://pat.zsmu.edu.ua/article/view/56113

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Original research