(16,17) In this scenario, as well as in cases where AFP is not performed, the use of additional hepatocellular antigens, such as hepatocyte-paraffin 1 and
glypican 3, is usually informative (Figure 1, F).
Expression and clinicopathologic significance of
glypican 3 in hepatocellular carcinoma.
The oncofetal gene
glypican 3 is regulated in the postnatal liver by zinc fingers and homeoboxes 2 and in the regenerating liver by alpha-fetoprotein regular 2.
Immunostaining for
glypican 3 (GPC3), heat-shock protein 70 (HSP70), and glutamine synthetase and/or gene expression (GPC3, lymphatic vessel endothelial hyaluronan receptor 1 [LYVE1], and survivin) are recommended to differentiate high-grade dysplastic nodules from early HCC.
Liver regeneration- as well as liver-specific genes (hepatocyte growth factor (HGF), a-fetoprotein (AFP), albumin (ALB),
glypican 3 (GPC3), tyrosine aminotransferase (TAT), hepatocyte nuclear factor 4A (HNF-4a), and cytochrome P450 1A2 (CYP1A2)) relative mRNA expression levels were determined by reverse transcription quantitative real-time PCR (RT-qPCR), by using the [2.sup.-[DELTA][DELTA]CT] method, on LightCycler[R] 480 System (Roche Diagnostics GmbH, Germany), using Maxima[R] SYBR Green/ROX kit (Thermo Fisher Scientific, DE, USA).
Given the lack of an etiology of the hyperammonemic encephalopathy and findings suggestive of fibrolamellar hepatocellular carcinoma, a liver biopsy was performed which confirmed the diagnosis through immunohistochemistry (Figure 2) which reports diffuse and intense expression for cytokeratin 7Y CD68, with marked sinusoidal capillarization with CD34 and expression for CD68 there is weak but diffuse expression for glutamine synthetase, and
glypican 3 and amyloid A are negative.
Fukayama, "Fetal type gastric carcinoma and its markers, SALL4,
glypican 3 and AFP," Stomach and Intestine(Tokyo), vol.
Some authors report a focal expression of cytokeratins [18] and also positivity for
Glypican 3 [19], which is a diagnostic marker expressed by hepatoblastoma and HCC.
Diagnostic value of HSP70,
glypican 3, and glutamine synthetase in hepatocellular nodules in cirrhosis.
Glypican 3 is a sensitive, but not a specific, marker for the diagnosis of yolk sac tumours.
This TF also suppresses
glypican 3 (GPC3) transcription [33].
Positive MUM-1, EMA, and Ki-67 Negative CD45, CD2, CD3, CD4, CD5, CD7, CD8, CD15, CD20, CD30, CD43, CD56, CD138, PAX5, TDT, HHV8, ALK1, myeloperoxidase, pan keratin, CAM5.2, CK5/6, CK7, CK20, monoclonal CEA, hepatocyte,
glypican 3, D2-40, calretinin, S100, SMA, desmin, myogenin, EBV-LMP1, and HHV8
