Spalt-like transcription factor 4 immunopositivity is associated with epithelial cell adhesion molecule expression in combined hepatocellular carcinoma and cholangiocarcinoma

作者：Tanaka Yuki; Aishima Shinichi; Kohashi Kenichi; Okumura Yukihiko; Wang Huanlin; Hida Tomoyuki; Kotoh Kazuhiro; Shirabe Ken; Maehara Yoshihiko; Takayanagi Ryoichi; Oda Yoshinao^*

来源：Histopathology, 2016, 68(5): 693-701.

DOI：10.1111/his.12806

• combined hepatocellular carcinoma and cholangiocarcinoma
• EpCAM
• immunohistochemistry
• SALL4

AimCombined hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) (cHCC-CC) is a rare biphasic liver cancer. Recent studies have demonstrated that cHCC-CC originates from hepatic progenitor cells (HPCs). Spalt-like transcription factor 4 (SALL4) is a marker for a progenitor subclass of HCC with an aggressive phenotype. However, little has been revealed about SALL4 expression in cHCC-CC. The aims of this study were to report SALL4 immunopositivity and the results of clinicopathological analysis in cHCC-CC, and to examine the two different nuclear immunostaining patterns for SALL4.
Methods and resultsWe defined the diffuse finely granular nuclear immunostaining pattern as immunopositive for SALL4; this was observed in eight (8.9%) of 90 cHCC-CCs. SALL4 immunopositivity was significantly associated with immunopositivity for -fetoprotein, glypican 3, and epithelial cell adhesion molecule (EpCAM). There was no relationship between SALL4 immunopositivity and prognosis. We confirmed SALL4 mRNA expression in samples with a punctuate/clumped immunostaining pattern, which showed a significantly lower rate of immunopositivity for EpCAM than those with a diffuse finely granular pattern.
ConclusionsSALL4 immunopositivity is not a prognostic factor in cHCC-CC; however, it is associated with -fetoprotein, glypican 3 and EpCAM immunopositivity, indicating the mechanism of carcinogenesis. Further study is necessary to interpret the immunostaining pattern for SALL4.

• 出版日期2016-4