Immunohistochemical analysis of HepPar-1, Glypican-3 and AFP expressions in the diagnostic approach of hepatocellular carcinomas

ABSTRACT
Aim: Liver cancer is an increasingly common malignancy associated with high mortality. It is the sixth most common cancer and the fourth the leading cause of cancer-releated death worldwide. In histopathological type determination, besides morphological features, immunohistochemical profile is also important. HepPar-1, AFP and Glypican-3 (GPC-3) are the main immunohistochemical markers used in the diagnosis of hepatocellular carcinoma (HCC) and differantiation from metastatic tumors.

Materials and Method: Hematoxylin/Eosin and immunohistochemical properties of resection and biopsy materials of 101 cases diagnosed with HCC between January 2019 and October 2021 were evaluated. HepPar-1, GPC-3 and AFP results are listed. The rates of positivity and negativity were determined for these three markers.

Results: HepPar-1 was positive in 85 (84.2%) of 101 cases, GPC-3 was positive in 76 (75.2%) cases and AFP was positive in 28 (27.7%) cases. There were 17 (16.83%) cases in which all 3 parameters were positive and 4 (3.96%) cases in which they were negative.When the positivity was evaluated in terms of 2 parameters, HepPar-1 and GPC-3 were positive in 49 (48.51%) cases, HepPar-1 ve AFP 5 (4.95%) cases,  AFP ve GPC-3 4 (3.96%) cases. The co-positivity of HepPar-1 and GPC-3 was found to be significantly higher.

Conclusion: We think that the inclusion of immunohistochemical markers such as HepPar-1, GPC-3 and AFP, which have been associated with hepatoid differentiation in the literature and have been reported to be valuable in terms of malignancy, in the diagnosis and differentiation of HCC from metastatic tumors, will be important in achieving an effective result.

Key words: AFP, Glypican-3, hepatocellular carcinoma, HepPar-1, liver cancer