Comparative immunohistochemical study of primary and metastatic carcinomas of the liver

Am J Clin Pathol. 1993 May;99(5):551-7. doi: 10.1093/ajcp/99.5.551.


Distinguishing primary hepatocellular carcinoma (HCC) from metastatic carcinomas to the liver is often difficult, if not impossible, particularly in needle biopsy and fine-needle aspiration specimens. In an attempt to identify a specific immunohistochemical profile that would distinguish HCC from metastatic carcinomas, we studied 56 HCCs, 8 cholangiocarcinomas, and 24 metastatic adenocarcinomas with monoclonal antibodies to alpha-fetoprotein (AFP), keratin (AE1, AE3, and CAM5.2), Leu-M1, human milk fat globule (HMFG-2), tumor-associated glycoprotein-72(B72.3), epithelial specific membrane antigen (Ber-EP4), and BCA-225 (CU-18). Both monoclonal and polyclonal (mCEA and pCEA) antibodies to carcinoembryonic antigen also were used. Metastatic adenocarcinomas were often positive for CU-18(71%), Leu-M1 (75%), B72.3 (50%), HMFG-2 (67%), Ber-EP4(83%) and mCEA(71%). Using these antibodies, the frequency of positivity for HCC was 9%, 16%, 11%, 20%, 36%, and 11%, respectively. CU-18 was the only monoclonal antibody in which there was a significant difference in positive rates between HCC and metastatic adenocarcinomas. Most HCCs (71%) revealed a bile canalicular staining pattern with pCEA. Because this staining pattern was absent in metastatic carcinomas, pCEA appears to be useful in confirming a diagnosis of HCC. AE1, AE3 and CAM5.2 antibodies were not useful in distinguishing HCC from metastatic carcinomas. Each cholangiocarcinoma shared a staining profile similar to that of metastatic carcinomas.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / chemistry
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / secondary*
  • Adenoma, Bile Duct / chemistry
  • Adenoma, Bile Duct / pathology*
  • Antibodies, Monoclonal
  • Antigens, Differentiation, Myelomonocytic / analysis
  • Carcinoembryonic Antigen / analysis
  • Carcinoma, Hepatocellular / chemistry
  • Carcinoma, Hepatocellular / pathology*
  • Diagnosis, Differential
  • Humans
  • Immunohistochemistry*
  • Keratins / analysis
  • Liver Neoplasms / chemistry
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / secondary*
  • Membrane Glycoproteins / analysis
  • Mucin-1
  • Retrospective Studies
  • alpha-Fetoproteins / analysis


  • Antibodies, Monoclonal
  • Antigens, Differentiation, Myelomonocytic
  • Carcinoembryonic Antigen
  • Membrane Glycoproteins
  • Mucin-1
  • alpha-Fetoproteins
  • Keratins