RESUMO
Distinguishing hepatocellular carcinoma (HCC) from metastatic tumors is a challenging issue, especially in differential diagnosis between poorly differentiated HCC and metastasis tumors. Expression of Arg-1, HepPar-1, and α-fetoprotein (AFP) in 78 cases of HCC, 34 cases of metastatic tumors, and 228 cases of nonhepatocellular tumors of surgical specimens is measured by immunohistochemistry. Arg-1 immunoreactivity was detected in 75 of 78 (96.1 %) cases of HCC, whereas HepPar-1 and AFP immunoreactivity was detected in 63 of 78 (80.7 %) and 40 of 78 (51.3 %) cases of HCC, respectively. HepPar-1 and AFP expression was observed in three of 34 (8.8 %) cases and one of 34 (2.9 %) cases of metastatic tumors, respectively. In contrast, Arg-1 expression was absent in all 34 (0 %) cases of metastatic tumors. The sensitivity, specificity, positive predictive value, and negative predictive value of Arg-1 in distinguishing HCC from metastatic tumors and nonhepatocellular tumors are 96.1, 99.6, 98.7, and 98.8 % compared with 80.7, 92.0, 75.0, and 94.1 % for HepPar-1 and 51.3, 97.7, 87.0, and 87.1 % for AFP, respectively. Arg-1 is a more sensitive and better specific marker for HCC compared with HepPar-1 and AFP, indicating that Arg-1 can be easily applied in distinguishing HCC from metastatic tumors.
Assuntos
Antígenos de Neoplasias/genética , Arginase/biossíntese , Carcinoma Hepatocelular/diagnóstico , Diagnóstico Diferencial , Neoplasias Hepáticas/diagnóstico , alfa-Fetoproteínas/biossíntese , Adulto , Idoso , Arginase/genética , Biomarcadores Tumorais/biossíntese , Biomarcadores Tumorais/genética , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/patologia , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Estimativa de Kaplan-Meier , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Prognóstico , alfa-Fetoproteínas/genéticaAssuntos
Tumor de Células da Granulosa/patologia , Neoplasias Ovarianas/patologia , Antígeno 12E7 , Anexos Uterinos/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos CD/metabolismo , Moléculas de Adesão Celular/metabolismo , Diagnóstico Diferencial , Feminino , Seguimentos , Tumor de Células da Granulosa/tratamento farmacológico , Tumor de Células da Granulosa/metabolismo , Tumor de Células da Granulosa/cirurgia , Humanos , Histerectomia/métodos , Inibinas/metabolismo , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/metabolismo , Neoplasias Ovarianas/cirurgia , Taxa de Sobrevida , Vimentina/metabolismoAssuntos
Meato Acústico Externo , Neoplasias da Orelha/patologia , Seminoma/patologia , Adenoma/metabolismo , Adenoma/patologia , Adulto , Fosfatase Alcalina/metabolismo , Anticorpos Monoclonais Murinos/metabolismo , Diagnóstico Diferencial , Neoplasias da Orelha/metabolismo , Neoplasias da Orelha/radioterapia , Neoplasias da Orelha/cirurgia , Proteínas Ligadas por GPI/metabolismo , Humanos , Isoenzimas/metabolismo , Linfoma Anaplásico de Células Grandes/metabolismo , Linfoma Anaplásico de Células Grandes/patologia , Masculino , Sarcoma de Mastócitos/metabolismo , Sarcoma de Mastócitos/patologia , Proteínas Proto-Oncogênicas c-kit/metabolismo , Seminoma/metabolismo , Seminoma/radioterapia , Seminoma/cirurgia , Vimentina/metabolismo , Adulto JovemRESUMO
<p><b>OBJECTIVE</b>To study the role of arginase-1 (Arg-1) expression in differential diagnosis of hepatocellular carcinoma (HCC), Arg-1 staining pattern in clear cell neoplasm (HCC and non-HCC) and Arg-1 expression in non-hepatocellular tumors.</p><p><b>METHODS</b>Seventy-eight cases of HCC (including 8 cases of clear cell type and 70 cases of non- clear cell type) and 246 cases of non-hepatocellular neoplasms (including 29 cases of metastatic tumors such as breast cancer, nasopharyngeal carcinoma and neuroendocrine carcinoma, 77 cases of tumors with clear cell changes such as malignant melanoma, clear cell renal cell carcinoma and alveolar soft part sarcoma, and 140 cases of other types of tumors such as ovarian endometrioid adenocarcinoma, pituitary tumor and thyroid papillary carcinoma) were studied.Immunohistochemical study for Arg-1 was performed on the paraffin-embedded tumor tissue.</p><p><b>RESULTS</b>In HCC, Arg-1 demonstrated both cytoplasmic and nuclear staining, with an overall sensitivity of 96.2% (75/78).In well, moderately and poorly differentiated HCC, the sensitivity was 15/15, 100% (41/41) and 86.4% (19/22), respectively. That was in contrast to negative staining for Arg-1 in all the 29 cases of metastatic tumors studied. The sensitivity, specificity, positive predictive value and negative predictive value of Arg-1 in distinguishing HCC from metastatic tumors was 96.2%, 100%, 100% and 90.6%, respectively. Cytoplasmic and membranous staining was observed in clear cell type of HCC. The overall sensitivity of Arg-1 expression in the 77 cases of tumors with clear cell changes was 14.3% (11/77), including 8/15 for malignant melanoma, 2/4 for ovarian clear cell carcinoma and 1/1 gall bladder adenocarcinoma with clear cell component.In malignant melanoma and ovarian clear cell carcinoma, only cytoplasmic staining was demonstrated. There was no expression of Arg-1 in the 140 cases of other tumor types studied.</p><p><b>CONCLUSIONS</b>Arg-1 is a sensitive and specific marker for HCC.It is a potentially useful immunohistochemical marker in distinguishing HCC from metastatic tumors. Though also expressed in malignant melanoma and ovarian clear cell carcinoma, Arg-1 shows a different staining pattern as compared with that in HCC.</p>
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adenocarcinoma , Arginase , Metabolismo , Carcinoma Hepatocelular , Patologia , Diferenciação Celular , Diagnóstico Diferencial , Neoplasias da Vesícula Biliar , Neoplasias Hepáticas , Patologia , Melanoma , Neoplasias Ovarianas , Neoplasias Gástricas , PatologiaRESUMO
<p><b>OBJECTIVE</b>To study the clinicopathologic features and differential diagnosis of blastic plasmacytoid dendritic cell neoplasm.</p><p><b>METHODS</b>The clinical, morphology and immunophenotypic features were analyzed in 3 cases of blastic plasmacytoid dendritic cell neoplasm, with review of literature.</p><p><b>RESULTS</b>The pathologic changes of these tumors accorded with that of blastic plasmacytoid dendritic cell neoplasm, and they also had new characteristics, including lineage other than T, B, myeloid and NK cells, and immunophenotypes of CD56(+) CD4(-) CD123(+) TdT(+) CD43(+) CD68(+) , CD56(+) CD4(+) CD123(-) TdT(+) CD43(+) CD68(-) and CD56(+) CD4(+) CD123(-/+) TdT(-) CD43(+) CD68(+) in the 3 cases, respectively. Bone marrow involvement was found 5 years later in case 1, and was then stable after chemotherapy; case 2 and case 3 were died 5 and 2 months after diagnosis, respectively.</p><p><b>CONCLUSION</b>Blastic plasmacytoid dendritic cell neoplasm is a heterogeneous group of lymphoproliferative disorders, with different clinical, morphologic and immunophenotypic features.</p>
