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World J Hepatol. Jun 8, 2015; 7(10): 1403-1411
Published online Jun 8, 2015. doi: 10.4254/wjh.v7.i10.1403
Current concepts in the immunohistochemical evaluation of liver tumors
Anne K Koehne de Gonzalez, Marcela A Salomao, Stephen M Lagana
Anne K Koehne de Gonzalez, Marcela A Salomao, Stephen M Lagana, Department of Pathology and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, United States
Author contributions: Koehne de Gonzalez AK, Salomao MA and Lagana SM contributed to this paper; the manuscript and table were drafted by Koehne de Gonzalez AK and Lagana SM with input from Salomao MA; the photomicrographs were taken and annotated by Salomao MA.
Conflict-of-interest: The authors report no competing financial interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Stephen M Lagana, MD, Department of Pathology and Cell Biology, College of Physicians and Surgeons, Columbia University, 630 W. 168th St., New York, NY 10032, United States. sml2179@cumc.columbia.edu
Telephone: +1-212-3056719
Received: October 28, 2014
Peer-review started: October 28, 2014
First decision: December 17, 2014
Revised: January 1, 2015
Accepted: March 4, 2015
Article in press: March 5, 2015
Published online: June 8, 2015
Abstract

Immunohistochemistry often plays an important role in the evaluation of liver tumors. Recent advances have established a classification system for hepatocellular adenomas (HCAs) based on morphology, molecular alterations, and immunohistochemistry. Specifically, loss of liver fatty acid binding protein is seen in HNF1α-inactivated HCA, staining with serum amyloid A is seen in inflammatory HCA, and diffuse staining with glutamine synthetase (GS) is seen in β-catenin activated HCA. A panel of immunohistochemical stains including glypican-3 (GPC-3), heat shock protein 70, and GS are useful in distinguishing HCC from non-malignant dysplastic nodules. Immunohistochemistry is also useful to determine whether a liver tumor is of primary hepatocellular or metastatic origin. Recently described markers useful for this purpose include arginase-1, GPC-3, and bile salt export pump. These newer markers may offer superior utility when compared to traditional markers of hepatocellular differentiation such as alpha-fetoprotein, hepatocyte paraffin-1, polyclonal carcinoembryonic antigen, and CD10. This paper will review recent advances in the immunohistochemical evaluation of liver tumors.

Keywords: Immunohistochemistry, Hepatocellular adenoma, Focal nodular hyperplasia, Hepatocellular carcinoma

Core tip: Immunohistochemical stains may be an important complement to morphology in the characterization of liver tumors. Immunohistochemical stains can now be used to subtype hepatocellular adenomas. A panel of immunohistochemical stains can help distinguish hepatocellular carcinoma from dysplastic nodules and hepatocellular adenomas. Several new markers of hepatocellular differentiation have been described. These advances are reviewed.