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Ki-67 “hot spot” digital analysis is useful in the distinction of hepatic adenomas and well-differentiated hepatocellular carcinomas

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Abstract

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.

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Authors and Affiliations

  1. Clinical Pathology Associates, Austin, TX, USA

    Andrea Jones

  2. Pathology Research Core, Mayo Clinic, Rochester, MN, USA

    Trynda N. Kroneman & Anthony J. Blahnik

  3. Department of Laboratory Medicine and Pathology, Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA

    Rondell P. Graham, Taofic Mounajjed, Michael S. Torbenson & Roger K. Moreira

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  1. Andrea Jones
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  2. Trynda N. Kroneman
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  3. Anthony J. Blahnik
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  4. Rondell P. Graham
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  5. Taofic Mounajjed
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  6. Michael S. Torbenson
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  7. Roger K. Moreira
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Correspondence to Roger K. Moreira.

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Jones, A., Kroneman, T.N., Blahnik, A.J. et al. Ki-67 “hot spot” digital analysis is useful in the distinction of hepatic adenomas and well-differentiated hepatocellular carcinomas. Virchows Arch 478, 201–207 (2021). https://doi.org/10.1007/s00428-020-02868-8

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  • DOI: https://doi.org/10.1007/s00428-020-02868-8

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