Choi Won-Tak, Ramachandran Rageshree, Kakar Sanjay
Department of Pathology, University of California at San Francisco, San Francisco, CA 94143.
Department of Pathology, University of California at San Francisco, San Francisco, CA 94143.
Hum Pathol. 2017 May;63:1-13. doi: 10.1016/j.humpath.2016.12.025. Epub 2017 Jan 11.
Well-differentiated hepatocellular carcinoma (HCC) shares overlapping histological features with benign hepatocellular lesions, including hepatocellular adenoma and focal nodular hyperplasia in non-cirrhotic liver, and with high-grade dysplastic nodule in cirrhotic liver. Several metastatic tumors, such as neuroendocrine tumor, renal cell carcinoma, adrenocortical carcinoma, melanoma, and epithelioid angiomyolipoma, can be indistinguishable from HCC on histologic grounds. Since this distinction has important therapeutic implications, judicious use of immunohistochemical markers plays an important role in establishing an accurate diagnosis, especially when limited material of tumor is available on cell block or a small core biopsy. This review describes commonly used immunohistochemical markers used in the diagnosis of HCC, highlighting advantages and disadvantages of each marker, and suggests appropriate immunohistochemical panels for specific clinicopathologic situations.
高分化肝细胞癌（HCC）与良性肝细胞病变具有重叠的组织学特征，包括非肝硬化肝脏中的肝细胞腺瘤和局灶性结节性增生，以及肝硬化肝脏中的高级别发育异常结节。一些转移性肿瘤，如神经内分泌肿瘤、肾细胞癌、肾上腺皮质癌、黑色素瘤和上皮样血管平滑肌脂肪瘤，在组织学上可能与HCC难以区分。由于这种区分具有重要的治疗意义，明智地使用免疫组化标志物在准确诊断中起着重要作用，尤其是当细胞块或小芯针活检获得的肿瘤材料有限时。本综述描述了用于HCC诊断的常用免疫组化标志物，强调了每种标志物的优缺点，并针对特定临床病理情况提出了合适的免疫组化组合。
