Canalicular immunostaining of aminopeptidase N (CD13) as a diagnostic marker for hepatocellular carcinoma

J Clin Pathol. 2005 Oct;58(10):1069-75. doi: 10.1136/jcp.2005.026328.

Abstract

Background: Aminopeptidase N (CD13) is expressed in normal and neoplastic liver tissue, where it exhibits a characteristic canalicular pattern (CD13(can)), similar to that seen for CD10 and when antibodies crossreact with biliary glycoprotein I (p-CEA).

Aim: To compare the putative diagnostic use of CD13(can) in differentiating between hepatocellular (HCC) and non-hepatocellular carcinomas metastatic to the liver (non-HCC).

Methods: A retrospective study comparing 53 HCC specimens with 32 non-HCC specimens. Immunostaining was performed with HepPar1 and antibodies directed against CD10, CD13, p-CEA, and alpha fetoprotein (AFP).

Results: In the HCC group, a canalicular staining pattern was found for CD13, p-CEA, and CD10 in 51, 43, and 33 specimens, respectively. HepPar1 was positive in 29 and AFP in 17 HCC specimens. In the non-HCC group, canalicular immunostaining for CD10 and p-CEA was confined to non-neoplastic liver tissue. One poorly differentiated cholangiocarcinoma showed apical expression of CD13, resembling to some extent CD13(can). Sensitivity and specificity were 96.2% and 97.0%, respectively, for CD13(can), 81.1% and 100% for p-CEA(can), 62.3% and 100%, for CD10(can), 54.7% and 99.9% for HepPar1, and 32.1% and 100% for AFP.

Conclusions: These results show that CD13(can) is more sensitive in differentiating between HCC and non-HCC than CD10(can), p-CEA(can), HepPar1, and AFP.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antigens, CD
  • Bile Canaliculi / metabolism*
  • Bile Duct Neoplasms / diagnosis
  • Bile Ducts, Intrahepatic
  • Biomarkers, Tumor / analysis*
  • CD13 Antigens / analysis*
  • Carcinoembryonic Antigen / analysis
  • Carcinoma, Hepatocellular / diagnosis*
  • Cell Adhesion Molecules
  • Cholangiocarcinoma / diagnosis
  • Diagnosis, Differential
  • Female
  • Glycoproteins / analysis
  • Humans
  • Immunoenzyme Techniques
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / secondary
  • Male
  • Middle Aged
  • Neprilysin / metabolism
  • Retrospective Studies
  • Sensitivity and Specificity
  • alpha-Fetoproteins / metabolism

Substances

  • Antigens, CD
  • Biomarkers, Tumor
  • CD66 antigens
  • Carcinoembryonic Antigen
  • Cell Adhesion Molecules
  • Glycoproteins
  • alpha-Fetoproteins
  • CD13 Antigens
  • Neprilysin