Diagnostic Utility of Clusterin in Fine Needle Aspiration Biopsy and Core Biopsies of Hepatocellular Carcinoma.

IF 1 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY

Diagnostic Cytopathology Pub Date : 2025-04-08 DOI:10.1002/dc.25473

Bhawana Dhiman, Reetu Kundu, Radhika Srinivasan, Suvradeep Mitra, Naveen Kalra, Madhumita Premkumar, Ajay Kumar Duseja

{"title":"Diagnostic Utility of Clusterin in Fine Needle Aspiration Biopsy and Core Biopsies of Hepatocellular Carcinoma.","authors":"Bhawana Dhiman, Reetu Kundu, Radhika Srinivasan, Suvradeep Mitra, Naveen Kalra, Madhumita Premkumar, Ajay Kumar Duseja","doi":"10.1002/dc.25473","DOIUrl":null,"url":null,"abstract":"Background: Several immunohistochemical markers are available for demonstrating hepatocytic differentiation, thereby confirming the diagnosis of hepatocellular carcinoma (HCC). Clusterin is a new marker of malignant hepatocytes, not evaluated in fine needle aspiration biopsy (FNAB) samples. Hence, we evaluated its diagnostic utility in FNAB cell blocks (CB) and core biopsy samples.Methods: A total of 47 cases of HCC diagnosed on FNAB with CB (41)/core biopsy (6) were retrieved. For comparison, CB from metastatic adenocarcinoma (15) and cases with incidental benign hepatocytes (12) were included. Immunohistochemistry (IHC) for clusterin was performed and the 3 groups were compared to derive its sensitivity and specificity. Canalicular expression was considered positive for hepatocytic differentiation.Results: The cohort comprised 47 cases of HCC, with 43 (91.5%) male and 4 (8.5%) female patients with an age range of 20-78 years. On clusterin IHC, benign hepatocytes showed a track-like canalicular pattern whereas in HCC, typical enhanced canalicular positivity (3+ intensity) was seen in 32/47 (68%) cases, 17 of which additionally showed cytoplasmic positivity. Only cytoplasmic positivity was noted in 7 HCC cases and was considered negative. All cases of well differentiated (6/6), 67.6% (25/37) of moderately differentiated, and 25% (1/4) of poorly differentiated HCC showed enhanced canalicular positivity, whereas metastatic adenocarcinoma showed cytoplasmic (2/15) or nucleocytoplasmic (1/15) positivity only.Conclusion: IHC for clusterin with enhanced canalicular pattern of expression revealed 68% sensitivity and 100% specificity for HCC, aiding its distinction from metastatic adenocarcinoma and benign hepatocytes in FNAB samples, thereby confirming its diagnostic utility.","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0000,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostic Cytopathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/dc.25473","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Several immunohistochemical markers are available for demonstrating hepatocytic differentiation, thereby confirming the diagnosis of hepatocellular carcinoma (HCC). Clusterin is a new marker of malignant hepatocytes, not evaluated in fine needle aspiration biopsy (FNAB) samples. Hence, we evaluated its diagnostic utility in FNAB cell blocks (CB) and core biopsy samples.

Methods: A total of 47 cases of HCC diagnosed on FNAB with CB (41)/core biopsy (6) were retrieved. For comparison, CB from metastatic adenocarcinoma (15) and cases with incidental benign hepatocytes (12) were included. Immunohistochemistry (IHC) for clusterin was performed and the 3 groups were compared to derive its sensitivity and specificity. Canalicular expression was considered positive for hepatocytic differentiation.

Results: The cohort comprised 47 cases of HCC, with 43 (91.5%) male and 4 (8.5%) female patients with an age range of 20-78 years. On clusterin IHC, benign hepatocytes showed a track-like canalicular pattern whereas in HCC, typical enhanced canalicular positivity (3+ intensity) was seen in 32/47 (68%) cases, 17 of which additionally showed cytoplasmic positivity. Only cytoplasmic positivity was noted in 7 HCC cases and was considered negative. All cases of well differentiated (6/6), 67.6% (25/37) of moderately differentiated, and 25% (1/4) of poorly differentiated HCC showed enhanced canalicular positivity, whereas metastatic adenocarcinoma showed cytoplasmic (2/15) or nucleocytoplasmic (1/15) positivity only.

Conclusion: IHC for clusterin with enhanced canalicular pattern of expression revealed 68% sensitivity and 100% specificity for HCC, aiding its distinction from metastatic adenocarcinoma and benign hepatocytes in FNAB samples, thereby confirming its diagnostic utility.

查看原文本刊更多论文

聚簇素在肝细胞癌细针穿刺活检和核心活检中的诊断价值。

背景：几种免疫组织化学标志物可用于显示肝细胞分化，从而确认肝细胞癌（HCC）的诊断。聚簇素是一种新的恶性肝细胞标志物，在细针穿刺活检（FNAB）样本中未被评估。因此，我们评估了其在FNAB细胞块（CB）和核心活检样本中的诊断效用。方法：回顾性分析47例FNAB诊断HCC， CB /core活检(6)41例。为了进行比较，转移性腺癌（15例）和附带良性肝细胞（12例）的CB被包括在内。采用免疫组化（IHC）检测聚簇素，比较3组聚簇素的敏感性和特异性。小管表达被认为是肝细胞分化阳性。结果：该队列包括47例HCC患者，其中男性43例（91.5%），女性4例（8.5%），年龄在20-78岁之间。在聚簇免疫组化中，良性肝细胞表现为轨道样小管模式，而在HCC中，典型的小管阳性增强（3+强度）在32/47（68%）例中可见，其中17例还表现为细胞质阳性。7例HCC仅细胞质阳性，被认为是阴性。所有高分化（6/6）、中分化（25/37）和低分化（25% /4）的HCC均显示小管阳性增强，而转移性腺癌仅显示细胞质（2/15）或核细胞质（1/15）阳性。结论：强化小管型表达的聚簇素的免疫组化对HCC的敏感性为68%，特异性为100%，有助于区分FNAB样本中的转移性腺癌和良性肝细胞，从而证实了其诊断价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Diagnostic Cytopathology 医学-病理学

CiteScore

2.60

自引率

7.70%

发文量

163

审稿时长

3-6 weeks

期刊介绍： Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.