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Abstract Details
Ki-67 "Hot Spot" Digital Analysis Is Useful in the Distinction of Hepatic Adenomas and Well-Differentiated Hepatocellular Carcinomas
Virchows Arch. 2020 Jun 25. doi: 10.1007/s00428-020-02868-8. Online ahead of print.
Andrea Jones1, Trynda N Kroneman2, Anthony J Blahnik2, Rondell P Graham3, Taofic Mounajjed3, Michael S Torbenson3, Roger K Moreira4
Author information
1Clinical Pathology Associates, Austin, TX, USA.
2Pathology Research Core, Mayo Clinic, Rochester, MN, USA.
3Department of Laboratory Medicine and Pathology, Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA.
4Department of Laboratory Medicine and Pathology, Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA. Moreira.roger@mayo.edu.
Abstract
This study aims to investigate the utility of digital protocols for Ki-67 immunohistochemistry quantitative analysis ("hot spot" method) in the setting of well-differentiated hepatocellular neoplasms. Resection cases of typical hepatic adenomas (HAs) (n = 40), atypical HAs (n = 9), and well-differentiated hepatocellular carcinomas (WD HCCs) (n = 56) were selected. HAs were further classified by immunohistochemistry using antibodies against liver fatty acid binding protein, glutamine synthetase, B-catenin, hepatic serum amyloid A, and C-reactive protein. Ki-67 proliferative index by immunohistochemistry was evaluated in all cases by digital analysis using a modified neuroendocrine tumor "hot spot" protocol. The proliferative rate of HAs (typical, median 1.2% (range 0-7.4%) and atypical, median 1.0% (range 0.3-3%)) was significantly lower than that of WD HCCs (median 4.5%, range 0-49.8%) (P < 0.0001). Only a few (7.5%) of the adenomas (all inflammatory/telangiectatic type) had proliferative rates higher than 4%, compared to most (51%) of HCCs. Ki-67 is a potentially useful adjunct marker in the evaluation of WD hepatocellular neoplasms, as "hot spot" proliferative rates are consistently very low in HAs but vary significantly in WD HCCs.