This study aims to investigate the utility of digital protocols for Ki-67 immunohistochemistry quantitative analysis (“hot spot” method) in the setting of well-differentiated hepatocellular neoplasms. Resection cases of typical hepatic adenomas (HAs) (n = 40), atypical HAs (n = 9), and well-differentiated hepatocellular carcinomas (WD HCCs) (n = 56) were selected. HAs were further classified by immunohistochemistry using antibodies against liver fatty acid binding protein, glutamine synthetase, B-catenin, hepatic serum amyloid A, and C-reactive protein. Ki-67 proliferative index by immunohistochemistry was evaluated in all cases by digital analysis using a modified neuroendocrine tumor “hot spot” protocol. The proliferative rate of HAs (typical, median 1.2% (range 0–7.4%) and atypical, median 1.0% (range 0.3–3%)) was significantly lower than that of WD HCCs (median 4.5%, range 0–49.8%) (P < 0.0001). Only a few (7.5%) of the adenomas (all inflammatory/telangiectatic type) had proliferative rates higher than 4%, compared to most (51%) of HCCs. Ki-67 is a potentially useful adjunct marker in the evaluation of WD hepatocellular neoplasms, as “hot spot” proliferative rates are consistently very low in HAs but vary significantly in WD HCCs.

这项研究的目的是研究数字化协议用于Ki-67免疫组织化学定量分析（“热点”方法）在高度分化的肝细胞肿瘤中的作用。典型肝腺瘤（n  = 40），非典型性 肝癌（n = 9）和高分化肝细胞癌（WD HCC）的切除病例（n = 56）。使用针对肝脏脂肪酸结合蛋白，谷氨酰胺合成酶，B-catenin，肝血清淀粉样蛋白A和C反应蛋白的抗体，通过免疫组织化学进一步对HA进行分类。使用改良的神经内分泌肿瘤“热点”方案，通过数字分析在所有情况下通过免疫组织化学评估Ki-67增殖指数。HAs的增殖率（典型值，中位数1.2％（范围0–7.4％）和非典型值，中位数1.0％（范围0.3–3％））显着低于WD HCCs（中位数4.5％，范围0–49.8％）。 ）（P <0.0001）。与大多数（51％）肝癌相比，仅有少数（7.5％）腺瘤（所有炎症/毛细血管扩张型）的增生率高于4％。Ki-67是评估WD肝细胞肿瘤的潜在有用辅助标记物，因为HA的“热点”增殖率一直很低，而WD HCC则有很大差异。