Stromal morphological changes and immunophenotypic features of precancerous lesions and hepatocellular carcinoma

J Clin Pathol. 2019 Apr;72(4):295-303. doi: 10.1136/jclinpath-2018-205611. Epub 2019 Jan 4.

Abstract

Aims: To evaluate stromal histopathological features and immunostaining expression for differential diagnosis of low- and high-grade dysplastic nodules (HGDN) to early and progressed hepatocellular carcinomas (eHCC, pHCC).

Materials: We evaluated sinusoid capillarisation (SC), solitary artery (SA), ductular reaction (DR), stromal invasion and expression of six biomarkers (GPC3, HSP70, GS, CD34, CK19, EpCAM) in a series of 97 cases.

Results: Stromal morphological changes, including SC, DR and SA, exhibited significant differences in differential diagnosis. In one indicator, SC had the best sensitivity (90.00%) and accuracy (85.42%), and SA had the best specificity at 88.89 %. In combinations, SC +and SA +were favourable and optimal. The immunoreactivity of GPC3, HSP70 and GS increased significantly in line with the stepwise progression of hepatocarcinogenesis.

Conclusions: Stromal histopathology features are useful for diagnosing HGDN, eHCC and small HCC. The immunostaining panel of GPC3, HSP70 and GS can also be supplementary.

Keywords: carcinogenesis; early hepatocellular carcinoma; hepatocellular carcinoma; high-grade dysplastic nodule; immunohistochemistry.

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / analysis*
  • Carcinoma, Hepatocellular / chemistry*
  • Carcinoma, Hepatocellular / pathology*
  • Carcinoma, Hepatocellular / surgery
  • Female
  • Glutamate-Ammonia Ligase / analysis
  • Glypicans / analysis
  • HSP70 Heat-Shock Proteins / analysis
  • Humans
  • Immunohistochemistry
  • Immunophenotyping / methods
  • Liver Neoplasms / chemistry*
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Phenotype
  • Precancerous Conditions / metabolism*
  • Precancerous Conditions / pathology*
  • Precancerous Conditions / surgery
  • Predictive Value of Tests
  • Retrospective Studies
  • Stromal Cells / chemistry*
  • Stromal Cells / pathology*

Substances

  • Biomarkers, Tumor
  • GPC3 protein, human
  • Glypicans
  • HSP70 Heat-Shock Proteins
  • Glutamate-Ammonia Ligase