Context: Identifying the pathological diagnosis for patients with primary hepatocellular carcinoma (HCC) depends on recognizing the microscopic cytological morphology and pathological molecular marker expressions. However, there are nearly 100 markers of primary HCC, most of which are discretely distributed. Thus, the diagnostical process lacks certainty.
Aims: Settings and Design: A preliminary study.
Methods and material: A total of 37,012 pathological molecular markers were selected in this study from 1,034 randomly selected patients with primary HCC from January 2014 to June 2019. Patient information included demographic and pathological characteristics, immunohistochemical and blood biochemical indicators, and other biological laboratory data.
Statistical analysis used: The discriminant analysis method (parametric and non-parametric) was used in two-thirds of the dataset to quantitatively establish the discriminant equation of gender, age, and positive variables determined by the Cochran-Armitage trend test for pathologic grading. The remaining one-third dataset was used to verify the discriminative ability.
Results: According to the fitted discriminant equation, only CD34, CD68, Glypican-3, HepPar-1, and Ki-67 (%) exhibited high sensitivity for the diagnosis of primary HCC. Among these five indicators, glypican-3 demonstrated a relatively high correlation with Ki-67 (%). CK19 and CK7 were highly correlated. Glypican-3 demonstrated a higher positive rate in poorly differentiated tumors, whereas HepPar-1 exhibited a higher positive rate in well-differentiated tumors.
Conclusions: Gender, age, HepPar-1, Ki-67 (%), and Glypican-3 demonstrated higher accuracy in discriminating the pathological grades of I/II, but the ability to discriminate pathological grades III/IV was insufficient. Additionally, other factors were found to affect pathological grading.
Keywords: Age; Ki-67 (%); discriminant equation; gender; glypican-3; hepPar-1; primary hepatocellular carcinoma.