The significance of an immunohistochemical panel in histological classification of intrahepatic cholangiocarcinoma in liver biopsy specimens

Abstract

Abstract: Objective To investigate the optimal immunohistochemical panel for subclassifying intrahepatic cholangiocarcinoma (ICC) into small- and large-duct types from liver biopsy specimens by evaluating the expression of S-100P, CD56, MUC5AC, CRP, TFF-1, and N-cadherin. Methods Two hundred and fourteen surgical cases of ICC diagnosed by the department of pathology of Zhongshan Hospital Affiliated to Fudan University from December 2019 to December 2021 were retrospectively analyzed. The expression of S-100P, CD56, MUC5AC, CRP, TFF-1, and N-cadherin was detected by immunohistochemistry. An immunohistochemical panel with maximum diagnostic efficacy for histological classification in liver biopsy specimens was explored based on receiver operating characteristic curve (ROC) and area under curve (AUC) analyses. Seventy-seven paired puncture biopsy specimens and surgical resection specimens diagnosed as ICC from January 2022 to March 2023 were collected to verify the accuracy and consistency of the classification panel. Results In surgical specimens, S-100P, MUC5AC, and TFF-1 were mainly expressed in large-duct ICC (P<0.001), while CD56, CRP, and N-cadherin were mainly expressed in small-duct ICC (P<0.001). The combined detection of multiple biomarkers could improve the diagnostic accuracy when compared to any of the single biomarker (P<0.05). For large-duct type ICC, the panel of S-100P/MUC5AC/TFF-1 demonstrated optimal efficacy in diagnosis (AUC=0.943,95%CI:0.913~0.974), no significant statistical difference was observed between the combined TFF-1/S-100P and the triple panel (P=0.062); For small-duct type ICC, the panel of CD56/CRP/N-cadherin achieved optimal efficacy in the diagnosis (AUC=0.889,95%CI:0.842~0.937), while no significant statistical difference was observed between the combined CD56/CRP panel and the triple panel(P=0.099). The immunohistochemical panel of S-100P, CD56, TFF-1, and CRP presented the optimal classification model, which reached a strong consistency between biopsy pathology and surgical pathology (κ=0.814,P<0.001). Conclusion The immunohistochemical panel of S-100P, CD56, TFF-1, and CRP has maximum diagnostic efficacy for the histological classification of ICC in liver biopsy specimens, which provides a pathological basis for the clinical diagnosis and treatment.

Key words: Intrahepatic cholangiocarcinoma, Liver biopsy specimens, Immunohistochemistry, Classification

Wang Yulin, Ji Yuan, Guo Xinxin, Han Jing, Zhang Xin. The significance of an immunohistochemical panel in histological classification of intrahepatic cholangiocarcinoma in liver biopsy specimens[J]. Chinese Hepatolgy, 2026, 31(6): 816-821.

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