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HNF-1ß is a More Sensitive and Specific Marker Than C-Reactive Protein for Identifying Biliary Differentiation in Primary Hepatic Carcinomas.

Patil PA, Taddei T, Jain D, Zhang X. HNF-1ß is a More Sensitive and Specific Marker Than C-Reactive Protein for Identifying Biliary Differentiation in Primary Hepatic Carcinomas. Archives of pathology & laboratory medicine. 2022 Jan 2; 146(2):220-226.

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Abstract:

CONTEXT.—: Intrahepatic cholangiocarcinoma (iCCA) needs to be distinguished from hepatocellular carcinoma (HCC) and metastasis, and in the absence of any specific biliary markers, is often a diagnosis of exclusion. Hepatocyte nuclear factor (HNF)-1ß is a transcription factor that plays a critical role in bile duct system morphogenesis. OBJECTIVE.—: To investigate the diagnostic value of HNF-1ß to differentiate iCCA from HCC by immunohistochemistry and compare HNF-1ß with C-reactive protein (CRP), a previously identified marker for iCCA. DESIGN.—: Cases of iCCA (n = 75), combined hepatocellular-cholangiocarcinoma (cHCC-CCA) (n = 13) and HCC (n = 65) were included in the study. RESULTS.—: All cases of iCCA (74 of 74, 100%) expressed HNF-1ß compared with CRP expressed in 72.60% (53 of 73). The sensitivity and specificity of HNF-1ß to differentiate iCCA from HCC was 100% and 92.31%, whereas the sensitivity and specificity for CRP was 75.58% and 7.79%. The expression of HNF-1ß was greater in iCCA and the CCA component of cHCC-CCA compared with CRP (87 of 87, 100% versus 65 of 86, 75.58%; P < .001). On the contrary, CRP was more frequently expressed compared with HNF-1ß in HCC and HCC component of cHCC-CCA (71 of 77, 92.21% versus 6 of 78, 7.69%; P < .001). CONCLUSIONS.—: Our data indicate that HNF-1ß is a more sensitive and specific marker than CRP for the diagnosis of iCCA and to identify the CCA component in cHCC-CCA. Lack of HNF-1ß expression may be used to exclude iCCA from consideration in cases of adenocarcinomas of unknown primary.




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