CRP Versus SAA for Identification of Inflammatory Hepatic Adenomas.
Journal
Applied immunohistochemistry & molecular morphology : AIMM
ISSN: 1533-4058
Titre abrégé: Appl Immunohistochem Mol Morphol
Pays: United States
ID NLM: 100888796
Informations de publication
Date de publication:
01 10 2023
01 10 2023
Historique:
received:
07
12
2022
accepted:
04
08
2023
medline:
10
10
2023
pubmed:
12
9
2023
entrez:
12
9
2023
Statut:
ppublish
Résumé
Subtyping hepatic adenomas is important for patient management due to differing complication risks. Immunohistochemical staining with C-reactive protein (CRP) and serum amyloid-A (SAA) is widely accepted as a surrogate for molecular classification to identify inflammatory hepatocellular adenomas. Limited data, however, has been published on how these 2 stains compare for sensitivity. We conducted a large, multicenter, retrospective study to examine the sensitivity and staining characteristics of CRP and SAA in inflammatory hepatic adenomas, with focal nodular hyperplasia (FNHs) as a control group. Inflammatory adenomas were identified in 133 patients (average age 37 years, 109 were female). In all, 69.9% of cases were resection specimens and 90.2% of all cases showed positive staining for both CRP and SAA; 10 (7.5%) were positive for CRP only and 3 (2.3%) were positive for SAA only. CRP was more sensitive than SAA (97.74% vs. 92.48%, P -value = 0.0961) and showed more extensive and intense staining, with a significantly higher modified H-score ( P <0.001). Focal nodular hyperplasia can also show positive CRP and SAA staining but with a lower modified H-score ( P <0.0001). Based on beta-catenin and glutamine synthetase staining, 26 of inflammatory adenomas also had beta-catenin activation (19.5%). All 3 cases with positive SAA and negative CRP staining were beta-catenin activated. In contrast, the proportion of cases that were CRP positive and SAA negative was similar regardless of beta-catenin activation. The data affirms the strategy of using both CRP and SAA immunostains for hepatic adenoma subtyping and raises the awareness of the highly variable nature of SAA staining characteristics.
Identifiants
pubmed: 37698958
doi: 10.1097/PAI.0000000000001155
pii: 00129039-990000000-00126
doi:
Substances chimiques
C-Reactive Protein
9007-41-4
beta Catenin
0
Serum Amyloid A Protein
0
Biomarkers, Tumor
0
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
590-595Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
Références
Nault JC, Couchy G, Balabaud C, et al. Molecular classification of hepatocellular adenoma associates with risk factors, bleeding, and malignant transformation. Gastroenterology. 2017;152:880–94 e6.
Zucman-Rossi J, Jeannot E, Nhieu JT, et al. Genotype-phenotype correlation in hepatocellular adenoma: new classification and relationship with HCC. Hepatology. 2006;43:515–524.
Pilati C, Zucman-Rossi J. Mutations leading to constitutive active gp130/JAK1/STAT3 pathway. Cytokine Growth Factor Rev. 2015;26:499–506.
Yasir S, Chen ZE, Jain D, et al. Hepatic adenomas in patients 60 and older are enriched for HNF1A inactivation and malignant transformation. Am J Surg Pathol. 2022;46:786–92.
Rebouissou S, Franconi A, Calderaro J, et al. Genotype-phenotype correlation of CTNNB1 mutations reveals different ss-catenin activity associated with liver tumor progression. Hepatology. 2016;64:2047–61.
Miller GC, Campbell CM, Manoharan B, et al. Subclassification of hepatocellular adenomas: practical considerations in the implementation of the Bordeaux criteria. Pathology. 2018;50:593–599.
Bioulac-Sage P, Rebouissou S, Thomas C, et al. Hepatocellular adenoma subtype classification using molecular markers and immunohistochemistry. Hepatology. 2007;46:740–748.
Larson BK, Guindi M. A limited immunohistochemical panel can subtype hepatocellular adenomas for routine practice. Am J Clin Pathol. 2017;147:557–570.
Fonseca S, Hoton D, Dardenne S, et al. Histological and immunohistochemical revision of hepatocellular adenomas: a learning experience. Int J Hepatol. 2013;2013:398308.
van Aalten SM, Verheij J, Terkivatan T, et al. Validation of a liver adenoma classification system in a tertiary referral centre: implications for clinical practice. J Hepatol. 2011;55:120–125.
Sasaki M, Yoneda N, Kitamura S, et al. Characterization of hepatocellular adenoma based on the phenotypic classification: The Kanazawa experience. Hepatol Res. 2011;41:982–988.
Bellamy CO, Maxwell RS, Prost S, et al. The value of immunophenotyping hepatocellular adenomas: consecutive resections at one UK centre. Histopathology. 2013;62:431–445.
Shafizadeh N, Genrich G, Ferrell L, et al. Hepatocellular adenomas in a large community population, 2000 to 2010: reclassification per current World Health Organization classification and results of long-term follow-up. Hum Pathol. 2014;45:976–983.
Margolskee E, Bao F, de Gonzalez AK, et al. Hepatocellular adenoma classification: a comparative evaluation of immunohistochemistry and targeted mutational analysis. Diagn Pathol. 2016;11:27.
Joseph NM, Ferrell LD, Jain D, et al. Diagnostic utility and limitations of glutamine synthetase and serum amyloid-associated protein immunohistochemistry in the distinction of focal nodular hyperplasia and inflammatory hepatocellular adenoma. Mod Pathol. 2014;27:62–72.
Paradis V, Benzekri A, Dargere D, et al. Telangiectatic focal nodular hyperplasia: a variant of hepatocellular adenoma. Gastroenterology. 2004;126:1323–1329.
Digestive Systems Tumors WHO Classification of Tumors, 5th edition. Lyon, France: International Agency fo Research on Cancer; 2019.
Torbenson MS, Zen Y, Yeh MM, et al. Tumors of the liver. Published by the American Registry of Pathology, Washington, DC, 2018;xv:449.
McCarty KS Jr, Miller LS, Cox EB, et al. Estrogen receptor analyses. Correlation of biochemical and immunohistochemical methods using monoclonal antireceptor antibodies. Arch Pathol Lab Med. 1985;109:716–721.
Bioulac-Sage P, Cubel G, Taouji S, et al. Immunohistochemical markers on needle biopsies are helpful for the diagnosis of focal nodular hyperplasia and hepatocellular adenoma subtypes. Am J Surg Pathol. 2012;36:1691–1699.