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Arginase‐1: A novel immunohistochemical marker of hepatocellular differentiation in fine needle aspiration cytology
Author(s) -
McKnight Ryan,
Nassar Aziza,
Cohen Cynthia,
Siddiqui Momin T.
Publication year - 2012
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.29
H-Index - 57
eISSN - 1934-6638
pISSN - 1934-662X
DOI - 10.1002/cncy.21184
Subject(s) - arginase , hepatocellular carcinoma , immunohistochemistry , pathology , medicine , metastatic carcinoma , glypican 3 , fine needle aspiration , cirrhosis , carcinoma , cancer research , biopsy , biology , biochemistry , amino acid , arginine
BACKGROUND: Arginase‐I is a key urea cycle metalloenzyme that has been used as an immunohistochemistry (IHC) marker for hepatocellular carcinoma (HCC). Previous studies have demonstrated the efficacy of HepPar‐1 and glypican‐3 (GPC‐3) IHC in liver fine needle aspiration (FNA) cytology. METHODS: Arginase‐1 IHC was performed on FNA cell blocks, and its performance characteristics were compared with HepPar‐1 and GPC‐3. Ninety‐two formalin‐fixed, paraffin‐embedded cell blocks were selected (HCC [n = 44], cirrhosis [n = 2], focal nodular hyperplasia [n = 3], hepatic adenomas [n = 2], dysplastic nodules [n = 6], and metastatic carcinomas [n = 35]). IHC staining with antibodies directed against arginase‐1, HepPar‐1, and GPC‐3 was performed with appropriate positive and negative controls. RESULTS: Arginase‐1 positivity was demonstrated in 37 of 44 (84.1%) cases of HCC, compared with 32 of 44 cases (72.7%) and 25 of 44 cases (56.8%) for HepPar‐1 and GPC‐3, respectively. Arginase‐1 and GPC‐3 expression were not observed in any cases of metastatic carcinoma (0%), whereas HepPar‐1 expression was present in 1 case of metastatic carcinoma. In addition, both arginase‐1 and HepPar‐1 expression were present in all 13 cases (100%) of nonmalignant hepatocellular lesions, whereas GPC‐3 expression was absent in all 13 cases (0%). CONCLUSION: This study demonstrates that both arginase‐1 and HepPar‐1 are effective IHC markers of hepatocellular differentiation. Furthermore, arginase‐1 demonstrates superior sensitivity compared with GPC‐3 and HepPar‐1 in the diagnosis of HCC, whereas GPC‐3 demonstrates superior specificity, as staining is not observed in benign hepatocellular lesions. Hence, use of arginase‐1 with HepPar‐1 and GPC‐3 can aid in the diagnosis of HCC and separating from metastatic carcinoma. Cancer (Cancer Cytopathol) 2012. © 2012 American Cancer Society.