Immunohistochemical Differentiation Between Intra-hepatic Cholangiocarcinoma and Hepatocellular Carcinoma: Insights From a Local Center's Expertise | ||||
| Zagazig University Medical Journal | ||||
| Article 9, Volume 31, Issue 5, May 2025, Page 1830-1837 PDF (1.89 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/zumj.2025.367210.3872 | ||||
 View on SCiNiTO | ||||
| Author | ||||
Sabah Mohamed Hanafy 
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| Pathology department, faculty of medicine, Zagazig University, Egypt. Laboratory Medicine Department, Applied Medical Science, Al Baha | ||||
| Abstract | ||||
| Background: The study aimed to investigate the use of immunohistochemistry (IHC) to distinguish between intra-hepatic cholangiocarcinoma (iCCA) and hepatocellular carcinoma (HCC) due to the rising incidence of iCCA and the limitations of radiological features in differentiation. Methods: A retrospective study was conducted on patients diagnosed with iCCA and HCC through guided biopsy interventions between 2018 and 2024 at the Pathology and Oncology Departments of Zagazig University, Egypt. Results: There were 42 patients in each of the two groups; the iCCA group and the HCC group. Most of HCC patients were HCV positive and cirrhotic (88.1% and 92.9%, respectively) compared to iCCA patients (50% and 52.4%). Tumor size >5 cm and multiple tumors were more common in HCC patients (73.8% and 88.1%) than in iCCA patients (64.3% and 78.6%). The median number of IHC stains was 5.68±2.07 for iCCA patients and 3.79±1.63 for HCC patients. Key IHC markers for iCCA were CK7, CK19, and CA19.9, while for HCC they were Hep Par 1, Arg-1, and GPC3. In iCCA patients, two specimens tested positive for GPC3, three for Arg-1, and two for Hep Par 1, all with low intensity expression. In HCC patients, one specimen tested positive for CK19, another for CK7, and a third for CA19.9, all showing weak positivity. Conclusion: CK7, CK19, and CA19.9 showed strong positivity in iCCA, while Hep Par 1, Arg-1, and GPC 3 were strongly positive in HCC. However, an accurate diagnosis relies on clinical context. Panels of stains provide more comprehensive information than individual stains. | ||||
| Keywords | ||||
| intra-hepatic cholangiocarcinoma; hepatocellular carcinoma; immunohistrochemistry | ||||
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