Diagnosis of
hepatocellular carcinoma (HCC) is not always easy on simple
hematoxylin and
eosin (H&E)
stain. The diagnostic problems arise when
tumor shows pseudoglandular, pleomorphic or clear cell differentiation. Various
tumors markers have been described with varying sensitivity and specificity.
Monoclonal antibody Hep Par 1 (OCH1E5) which is specific for hepatocytes offers great help in separation of these
tumors. The aim of the present study was to determine utility of Hep Par 1 (OCH1E5) in differentiating HCC from metastatic
tumors and
cholangiocarcinoma. Total of 62 cases of liver
tumors obtained from biopsies, resected or autopsy specimens were included in the study. Slides having representative sections were subjected to immunohistochemistry with
monoclonal antibody Hep Par 1 (Dako Corp) using
avidin biotin technique with primary antibody dilution of 1:40. Adjacent nontumorous hepatocytes were taken as positive control. Slides were examined by experienced pathologist without any information of clinical or H&E diagnosis. Cases were considered positive for Hep Par 1 if
tumor cells showed cytoplasmic brown colored granules. The intensity and distribution (diffuse/ focal) of immunoreactivity was noted. Subsequently immunohistochemistry results were correlated with histology and clinical diagnosis. Hep Par 1 antibody was positive in 26 (42 %) and negative in 36 (58 %) liver
tumors. On correlating with H&E sections, out of 26 positive cases, 25 (89.2%) were HCC and one was the case of
metastasis of
mucin secreting
adenocarcinoma. From 36
tumors with negative staining 3 were cases of HCC, 27 metastatic
adenocarcinomas and 6
cholangiocarcinomas. Only one case of liver
metastasis of
mucin secreting
adenocarcinoma showed positivity. None of the cases of
cholangiocarcinoma showed positivity for Hep Par 1. The three HCCs which did not take up staining for Hep Par 1 were 2 cases of moderately differentiated HCC having pseudoglandular pattern and a case of well differentiated HCC with trabecular arrangement. In 11(44%) cases staining was diffuse while in 14 (56%) it was focal but intense. Hep Par 1 is a useful marker in differentiating HCC from metastaic
tumors and
cholangiocarcinoma with sensitivity and specificity of 89 % and 97 % respectively and positive predictive value of 96 %. However one should be aware of limitations of immunohistochemistry.