| Abstract: |
The ann of this study to evaluate the hepatocellular carcinoma using immunohistochemical stains and image analyzer technique:1- Differentiation of the primary hepatic tumor from secondary tumors by (a-fetoprotein).2- To detect the relation of hepatocellular carcinoma and viral infection by orcein stain.3- Assessment of aggressiveness of tumor by using P53 and proliferation of tumors by PCNA immunohistochemical stains.4- Also, to evaluate the proliferative index and proliferation nuclear area of stained slides by PCNA and P53 respectively by CAS 200 image analysis system.This study was done at Internal Medicine, Radiology and Pathology Departments.70 patients with chronic hepatic diseases were submitted for investigations and FNA guided biopsy, 20 patients were ruled out. However, 50 patients specImens were subjected for conventional (Hx&E), orcein, and immunohistochemical stains (P5 3, PCNA & afetoprotein). In addition to assessment by image analysis (CAS 200).The result were as follow:- There was an overall male predominance in all cases of BCC, and the age of BCC cases range from 35-6~ years.- On the histopathological examination of BCC cases, grade II was the most frequent one and the trabecular pattern was; the most common histopathological type.Histochemical staining by orcem stain to detect hepatitis B surface antigen revealed that only 6 cases were positive for orcein stain, and there is no significant correlation between grades ofBCC and orcein staining.- There is a significant correlation between the degree of orcein staining and the grades of BCe. The degree (++) of staining is more presented in grade IV BCe.- As regard P53 immunostaining a significant correlation was proved with different histopathological grades ofHCC. The high percentage of P53 positivity (100%) was associated with grade IV BCC.-, A significant correlation was proved between P53 intensity of staining and HCC grades with the highest degree of staining (+++) in t,rrade IV HCC (50%).- Recent assessment of proliferating nuclear area (PNA) in P53 stained cases by cell analyzer technique (CAS 200) proved a significant correlation between the PNA and BCC grades with the highest PNA (48.9%) in grade IV BCC.- The study of cell proliferation and growth by the immunohistochemical detection of proliferating cell nuclear antigen (PCNA) revealed that an increased expression ofPCNA was associated with a high tumor grade and agf,JTessive behaviour of BCC.- By Semiquantitative method a significant correlation between PCNA positivity and histopathological grades of BCC was proved, the high percentage of PCNA positivity was detected in grade IV BCe.- There was a significant correlation between the PCNA degree of positivity and the grades of HCC with highest degree (++++) of PCNA staining was detected in grade IV HCC.The evaluation of proliferating cell nuclear antigen by cell image analyzer technique proved a significant cOlTelation between the prol1feration index and different grades of HCC. It was found that a high (PI) was detected in grade IV HCC (50.2%).Immunocytochemical study of alphafetoprotein staining revealed no significant association between HCC grades and AFP positivity. However, a high percentage of AFP positivity was detected iil grade IV HCC.There is a significant association between the AFP degree of staining and different grades of HCC. The largest degree of staining (+++) was detected more in grade III HCCFrom this study it can be concluded that:• FN AB in addition to block preparation of smear is of high diagnostic accuracy of HCC.• Orcein stain is of limited value as it is detected only in few cases.• cx.-fetoprotein, PCNA, P53 have significant role for assessment of biological behaviour ofHCC.• Also assessment of immunohistochemical stained slides by image analysis was proved to be more significant than the semiquantative method.
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