OBJECTIVETo evaluate the significance of a panel of immunohistochemical markers for distinguishing hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICC).

METHODSTen markers including hepatocyte paraffin 1 (Hep Par 1), polyclonal carcinoembryonic antigen (pCEA), CD34, CD10, CD105, multidrug resistance-associated protein-3 (MRP-3), cyclooxygenase-2 (COX-2), mucinous glycoprotein-1 (MUC-1), aquaporin-1 (AQP-1) and CK19 were immunohistochemically stained in the samples from 90 surgically resected HCC and 80 ICC, respectively,and the positive rate of their expression were compared statistically.

RESULTSThe positive expression rates of Hep Par 1, pCEA, CD34, CD10, CD105, MRP-3, COX-2 were 85.6%, 82.2%, 87.8%, 18.9%, 8.9%, 11.1% and 48.9%, respectively, in HCC. While the positive expression rates of MUC-1, AQP-1 and CK19 were 73.8%, 65% and 92.5%, respectively, in ICC.

CONCLUSIONBased on our results, Hep Par 1 and CD34 can be used as the first line markers, and pCEA and COX-2 as the second line makers, for differential diagnosis of hepatocellular carcinoma from intrahepatic cholangiocarcinoma. While MUC-1 and CK19 can be used as the first line markers and AQP-1 as the second one for the differential diagnosis of intrahepatic cholangiocarcinoma from hepatocellular carcinoma.

Bile Duct Neoplasms ; chemistry ; diagnosis ; Bile Ducts, Intrahepatic ; chemistry ; Biomarkers, Tumor ; analysis ; Carcinoma, Hepatocellular ; chemistry ; diagnosis ; Cholangiocarcinoma ; chemistry ; diagnosis ; Diagnosis, Differential ; Female ; Hepatocytes ; chemistry ; pathology ; Humans ; Immunohistochemistry ; Liver Neoplasms ; chemistry ; diagnosis ; Male ; Middle Aged

BACKGROUNDSmad4 is found mutated in many cancers. It acts as a tumor suppressor in the regulation of TGF-β signaling pathway. The objective of this work was to study the expression of Smad4 in intrahepatic cholangiocarcinoma (ICC) and its relationship with the biological behavior and prognosis of the disease.

METHODSForty-nine paraffin-embedded ICC specimens and nine normal liver tissues were analyzed by immunohistochemical methods using Smad4 monoclonal antibodies. The expression of Smad4 was compared with the clinical pathological characteristics of the patients.

RESULTSThe expression of Smad4 was 100% positive in normal liver tissues, which was higher than that in the ICC (44.9%). Negative labeling of the Smad4 protein was found in 26.1% (6/23) of well-differentiated ICCs and 61.5% (16/26) of poorly to moderately differentiated ICCs, and 34.3% (12/35) and 71.4% (10/14) showed negative Smad4 labeling (P = 0.018) of ICC at pathological Tumor Node Metastasis (pTNM) stage I-II and pTNM stage III-IV separately. Furthermore, 72% (8/11) of lymph node metastatic ICCs and 73.3% (11/15) of intrahepatic metastatic ICCs showed negative labeling of the Smad4 protein. The loss of Smad4 expression in those metastatic ICCs was significantly more severe compared with non-metastatic ICCs (P = 0.000).

CONCLUSIONSThe expression of Smad4 was associated with the histological grade, clinical stage, and metastasis of ICC (P < 0.05). The detection of Smad4 may be helpful in determining the degree of malignancy and prognosis of ICC.

Adult ; Aged ; Bile Duct Neoplasms ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; chemistry ; pathology ; Female ; Humans ; Liver Neoplasms ; chemistry ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Signal Transduction ; physiology ; Smad4 Protein ; analysis ; genetics ; physiology ; Transforming Growth Factor beta ; physiology

No abstract available.
Adenoma, Bile Duct/pathology/*radiography ; Adult ; Aged ; Angiomyolipoma/pathology/*radiography ; Bile Duct Neoplasms/pathology/*radiography ; Bile Ducts, Intrahepatic ; Carcinoma, Hepatocellular/radiography ; Diagnosis, Differential ; Female ; Gadolinium DTPA/*chemistry ; Humans ; Liver Diseases/pathology/*radiography ; Liver Neoplasms/pathology/*radiography ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Pseudolymphoma/pathology/*radiography ; Tomography, X-Ray Computed

Granulocytic sarcoma (GS) is an extramedullary tumor composed of immature myeloid cells, typically occurring during the course of acute myelogenous leukemia. Non-leukemic GS, that is, GS with no evidence of overt leukemia and no previous history of leukemia, is very rare, and even more unusual is nonleukemic GS of the bile duct. We report a case of nonleukemic GS of the bile duct. The patient was initially misdiagnosed as a bile duct carcinoma arising in the hilum of the liver (so-called Klatskin tumor), and received a right lobectomy of the liver. Histological examination of the tumor yielded the diagnosis of GS, and the bone marrow biopsy did not show any evidence of leukemia. Considering the risk of subsequent development of overt leukemia, the patient was treated with two cycles of combination chemotherapy as used in the cases of acute myelogenous leukemia. To date, he has remained free of disease 15 months after treatment.
Tomography, X-Ray Computed/methods ; Sarcoma, Granulocytic/*diagnosis/metabolism/radiography ; Radiography, Abdominal ; Peroxidase/analysis ; Male ; Immunohistochemistry ; Humans ; Diagnosis, Differential ; Bile Ducts/chemistry/pathology ; Bile Duct Neoplasms/*chemically induced/metabolism/radiography ; Antigens, CD45/analysis ; Adult

We present a case report to show how manganese-enhanced T1- and T2-weighted MR cholangiography could differentiate cystic parenchymal lesions from cystic abnormalities which communicate with the bile ducts.
Bile Ducts/*pathology ; Cholangiopancreatography, Magnetic Resonance/*methods ; Choledochal Cyst/diagnosis ; Contrast Media/chemistry ; Cysts/diagnosis ; Diagnosis, Differential ; Humans ; Liver/*pathology ; Male ; Manganese/*chemistry ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity

No abstract available.
Bile Duct Neoplasms/complications/*diagnosis ; *Bile Ducts, Intrahepatic/chemistry/pathology/radiography ; Biopsy ; Cholangiocarcinoma/complications/*diagnosis ; Diagnosis, Differential ; Fever/diagnosis/*etiology ; Humans ; Immunohistochemistry ; Leukocytosis/*diagnosis/etiology ; *Liver/chemistry/pathology/radiography ; Liver Abscess, Pyogenic/*diagnosis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Paraneoplastic Syndromes/*diagnosis/etiology ; Predictive Value of Tests ; Tomography, Spiral Computed ; Tumor Markers, Biological/analysis

OBJECTIVETo elucidate the antifibrotic mechanism of Huangqi decoction in rats with BDL-induced cholestatic liver fibrosis.

METHODSLiver fibrosis model was induced by ligating the common bile duct (BDL) in rats. Sham-operation was performed in control rats. The BDL rats were randomly divided into two groups: the BDL group and the Huangqi decoction group. Huanqi decoction was given intragastrically for 4 weeks. At the end of the fifth week after BDL, animals were sacrificed.

RESULTSCompared with the sham control group, mortality rate in BDL group was 33.3% and incidence rate of ascites was 90%, and hepatic function was abnormal in most of the rats in BDL group. The number of Hepatocytes was decreased and the number of cholangiocytes significantly increased in BDL group. In addition, Hyp content of liver tissue and protein expression of CK 7 and a-SMA were significantly increased. Immunostaining indicated that CK 7 and a-SMA were co-localized in BDL group. These changes were markedly suppressed by the Huangqi decoction.

CONCLUSIONSThese observations suggest that Huangqi decoction can inhibit cholangiocyte proliferation and cholangiocyte transdifferentiation.

Actins ; metabolism ; Animals ; Astragalus Plant ; Bile Ducts ; pathology ; Cell Proliferation ; drug effects ; Cell Transdifferentiation ; drug effects ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Epithelial Cells ; drug effects ; Hyaluronic Acid ; metabolism ; Keratin-7 ; metabolism ; Liver ; metabolism ; pathology ; Liver Cirrhosis, Biliary ; drug therapy ; metabolism ; pathology ; Liver Function Tests ; Male ; Plants, Medicinal ; chemistry ; Rats ; Rats, Sprague-Dawley