An extralesional nontumoral sample was available in 30 cases; in addition, cases of low-grade dysplastic nodules (LGDNs; n = 15) and HGDNs (n = 16) were collected. All dysplastic nodules were confirmed to be nonmalignant because during follow-up (at least 12 months), they did not show evidence of malignant learn more changes. The median ages, gender distributions, HCC grading, and chronic liver disease etiologies
of the two HCC groups are reported in Table 1. Five consecutive recuts from the original paraffin blocks were obtained in all cases and were stained with antibodies against GPC3, HSP70, GS, and CHC. Supporting Table 2 details the
reagents used in this study, the working dilutions, and the detection system. Immunocytochemical analysis was performed according to standard procedures. Samples stained for GPC3 and HSP70 were scored as positive when at least 10% of the tumoral population showed undisputed cytoplasmic/membrane (GPC3) or nucleoplasmic/cytoplasmic (HSP70) staining. GS immunoreactivity was scored as positive when at least 50% of the neoplastic cells showed nucleoplasmic/cytoplasmic staining. Positive controls included an HCC case as an external standard for GPC3 and nonneoplastic bile duct epithelium and perivenular nontumoral hepatocytes Selleck Staurosporine as internal standards for HSP70 and GS, respectively. CHC-positive cases were considered to be those showing undisputed cytoplasmic antigen overexpression in more than 10% of the malignant hepatocytes in comparison with the surroundings, the latter being the extralesional sampling or nontumoral parenchyma adjacent to the core HCC.
Nonparenchymal cells such as endothelial cells were used as internal standards for CHC staining. The staining assessment was made by two pathologists (M.R. and L.D.T.) and was always based on antigen overexpression in the lesion versus the surroundings. until These pathologists independently evaluated the specimens and applied the designated criteria. The results were then discussed between them, and concordance on agreed scores was achieved with a high k coefficient value (>0.80). To further address the issue of interobserver variability in the evaluation of CHC immunostaining, we trained both a junior pathologist and a senior pathologist with a small set of surgical specimens and liver biopsy samples. Then, the junior and senior pathologists independently evaluated all the cases of HCC and dysplastic nodules, and the results were compared to the previously agreed scores.