Yonsei Med J.  1999 Oct;40(5):472-477. 10.3349/ymj.1999.40.5.472.

Expression of biliary antigen and its clinical significance in hepatocellular carcinoma

Affiliations
  • 1Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. young0608@yumc.yonsei.ac.kr
  • 2Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Surgery, Kwandong University Medical College, Kangnung, Korea.
  • 4Department of Surgery, Pochon CHA University College of Medicine, Kyungkido, Korea.

Abstract

In order to classify the hepatocellular carcinomas (HCCs) which had diverse clinicopathologic characteristics, we divided HCCs into two groups according to the expression of biliary antigen on the basis of the hypothesis that the hepatocyte and biliary epithelial cell originate from the same precursor cell, and then we investigated the clinical and pathologic characteristics in the two groups. Forty HCC cases with no preoperative treatment and at least two-year follow-up data were selected among 202 cases of HCC files from 1991 to 1995. Expression of biliary antigen (AE1, cytokeratin 19), p53, AFP, and Ki-67 in the tumor tissue were assessed by immunohistochemistry. Positive cytokeratin 19 was noted in one case (2.5%); AE1 was detected in 40% of patients; p53 was overexpressed in 20% of patients; and AFP was detected in 45% of patients. No statistical difference between the biliary antigen positive group (16 cases) and the negative group (24 cases) were noted in terms of mean age, sex, presurgical serum AFP level, Child class, and tumor size. HBsAg positive rate was 66.7% for the biliary antigen (-) group and 93.8% for the biliary antigen (+) group with a statistically significant difference (p = 0.048). The number of cases for Edmonson-Steiner grade I/II and III/IV were 15 and 9 in the biliary antigen (-) group, and 4 and 12 in the biliary antigen (+) group, respectively, with a statistically significant difference (p = 0.024). The 1, 3 and 5-year disease-free survival rates were 69.7, 40.9 and 40.9% for the biliary antigen (-) group and 73.7, 39.1, 39.1% for the biliary antigen (+) group with no statistically significant difference. The 1, 3 and 5-year overall survival rates were 91.7, 73.8, 66.4% for the biliary antigen (-) group and 68.8, 34.4, 34.4% for the biliary antigen (+) group, with a significantly greater overall survival rate for the biliary antigen negative group (p = 0.045). Poor histopathological differentiation, a high HBsAg positive rate and poor overall survival rate were noted in the biliary antigen positive group and the differences were statistically significant. In conclusion, HCCs with positive biliary antigen, which originates from more primitive cells, is suggested to be more aggressive than HCCs with negative biliary antigen.

Keyword

Hepatocellular carcinoma; biliary antigen; clinical significance

MeSH Terms

Adult
Aged
Bile Ducts/immunology*
Carcinoma, Hepatocellular/mortality
Carcinoma, Hepatocellular/chemistry*
Female
Human
Keratin/analysis*
Ki-67 Antigen/analysis
Liver Neoplasms/mortality
Liver Neoplasms/chemistry*
Male
Middle Age
Prognosis
Protein p53/analysis
Survival Rate
alpha-Fetoproteins/analysis
Full Text Links
  • YMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error