The assessment of proliferating cell nuclear antigen immunohistochemical staining in small hepatocellular carcinoma and its relationship to histologic characteristics and prognosis

Effect of preoperative transcatheter arterial chemoembolization on proliferation of hepatocellular carcinoma cells

AIM: To evaluate the effect of preoperative transcatheter arterial chemoembolization (TACE) on proliferation of hepatocellular carcinoma (HCC) cells.

METHODS: A total of 136 patients with HCC underwent liver resection. Of 136 patients, 79 patients received 1 to 5 courses of TACE prior to liver resection (TACE group), who were further subdivided into four groups: Group A (n = 11) who received 1 to 4 courses of chemotherapy alone; Group B (n = 33) who received 1 to 5 courses of chemotherapy combined with iodized oil; Group C (n = 23) who received 1 to 3 courses of chemotherapy combined with iodized oil and gelatin sponge; and Group D (n = 12) who received 1 to 3 courses of chemotherapy combined with iodized oil, ethanol and gelatin sponge. The other 57 patients only received liver resection (non-TACE group). The expressions of Ki-67 and proliferating cell nuclear antigen (PCNA) protein were detected in the liver cancer tissues by immunohistochemical method.

RESULTS: The Ki-67 protein expression was significantly lower in Groups C and D as compared with non-TACE group (31.35% ± 10.85% vs 44.43% ± 20.70%, 30.93% ± 18.10% vs 44.43% ± 20.70%, respectively, P < 0.05). The PCNA protein expression was significantly lower in Groups C and D as compared with non-TACE group (49.61% ± 15.11% vs 62.92% ± 17.21%, 41.16% ± 11.83% vs 62.92% ± 17.21%, respectively, P < 0.05). The Ki-67 protein expression was significantly higher in Group A as compared with non-TACE group (55.44% ± 13.72% vs 44.43% ± 20.70%, P < 0.05). The PCNA protein expression was significantly higher in Groups A and B as compared with non-TACE group (72.22% ± 8.71% vs 62.92% ± 17.21%, 69.91% ± 13.38% vs 62.92% ± 17.21%, respectively, P < 0.05).

CONCLUSION: Preoperative multi-material TACE suppresses the proliferation of HCC cells, while a single material embolization and chemotherapy alone enhance the proliferation of HCC cells.

Comparative study on proliferation activity in small hepatocellular carcinoma related to hepatitis virus B and C

AIM: To compare the proliferation activity of small hepatocellular carcinoma (HCC) related to hepatitis B virus (HBV) and hepatitis C virus (HCV).

METHODS: Sixty liver biopsy specimens were obtained from patients with small HCC (≤3 cm in diameter) and examined immunohistochemically using anti-proliferating cell nuclear antigen monoclonal antibody. Of the 60 specimens, 30 were HBV-related and 30 were HCV-related. The 60 patients providing the samples for study were matched by sex and morphologic features of the HCC specimens.

RESULTS: The labeling index of proliferating cell nuclear antigen was 7.9% in the HBV-related HCC specimens and 12.5% in the HCV-related HCC specimens. There was no statistically significant difference between the two groups (P > 0.05).

CONCLUSION: In the early phase, or small stage, of HCC, HBV-related HCC shows similar proliferating activity to that of HCV-related HCC; this finding suggests that in the early phase, HBV-related HCC has similar malignancy to HCV-related HCC.