Diagnostic utility of Glut‐1 and CA 15‐3 in discriminating adenocarcinoma from hepatocellular carcinoma in liver tumors biopsied by fine‐needle aspiration

• Published in: Cancer Vol. 96; no. 1; pp. 53 - 57
• Main Authors: Zimmerman, Robert L., Burke, Melissa, Young, Nancy A., Solomides, Charalambos C., Bibbo, Marluce
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 25-02-2002; Wiley-Liss
• Subjects: Adenocarcinoma - diagnosis; Adenocarcinoma - pathology; Biological and medical sciences; Biopsy, Needle; CA 15‐3; Carcinoma, Hepatocellular - diagnosis; Carcinoma, Hepatocellular - pathology; Diagnosis, Differential; Digestive system; fine‐needle aspiration biopsy; Glucose Transporter Type 1; Glut‐1; hepatocellular carcinoma (HCC); Hepatocytes; Humans; Investigative techniques, diagnostic techniques (general aspects); liver; Liver Neoplasms - diagnosis; Liver Neoplasms - pathology; Liver Neoplasms - secondary; Medical sciences; metastases; Monosaccharide Transport Proteins - analysis; Mucin-1 - analysis; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Sensitivity and Specificity; Adenocarcinoma; Immunohistochemistry; Carbohydrate antigen; Tumor associated antigen; Antigen CA 15 3; Hepatic disease; Hepatocellular carcinoma; Tumoral marker; Malignant tumor; Glucose; Fine needle aspiration biopsy; Pathology; Digestive diseases; Cytopathology; Diagnosis; Carrier protein
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.10309

BACKGROUND
Diagnosing liver tumors can be difficult in the setting of a poorly differentiated tumor or tumors with no known prior malignancy. Frequently, α‐fetoprotein, carcinoembryonic antigen, factor VIII, and mucicarmine have been employed to distinguish hepatocellular carcinoma (HCC) from adenocarcinoma. However, these stains have their limitations. CA 15‐3 and Glut‐1 are expressed in a variety of carcinomas. To the authors' knowledge, their expression in HCC has not been studied extensively. The authors examined the clinical utility of CA 15‐3 and Glut‐1 in the setting of fine‐needle aspiration biopsy samples from the liver.
METHODS
Thirty‐five cases of HCC and 59 cases of tumors metastatic to the liver were studied. These cases previously were studied with the hepatocyte paraffin‐1 antibody. Each case was stained with CA 15‐3 and Glut‐1 using the avidin‐biotin complex method. Each case was evaluated in a blinded fashion for membranous staining that was stronger than cytoplasmic or background staining. The diagnoses were unblinded and staining patterns were compared.
RESULTS
CA 15‐3 stained 43 of 59 metastatic carcinoma samples and 3 of 35 HCC samples. Glut‐1 stained 34 of 59 metastases and 2 of 35 HCCs. Together, the 2 immunostains stained 51 of 59 metastases and 5 of 35 HCCs. Diagnostic accuracy was improved by adding hepatocyte paraffin‐1 to the staining panel.
CONCLUSIONS
CA 15‐3 and Glut‐1, especially in conjunction with hepatocyte paraffin‐1, appear to be helpful in discriminating HCC from other carcinomas. Cancer (Cancer Cytopathol) 2002;96:53–7. © 2002 American Cancer Society.
The CA 15‐3 and Glut‐1 antibodies are markers of carcinoma, but rarely stain hepatocellular carcinoma. These antibodies, especially in conjunction with the hepatocyte paraffin‐1 antibody, may help discriminate hepatocellular carcinoma from other carcinomas.