CRP Versus SAA for Identification of Inflammatory Hepatic Adenomas.

IF 1.3 4区 医学 Q3 ANATOMY & MORPHOLOGY Applied Immunohistochemistry & Molecular Morphology Pub Date : 2023-10-01 Epub Date: 2023-09-13 DOI:10.1097/PAI.0000000000001155
Gwyneth S T Soon, Saba Yasir, Dhanpat Jain, Sanjay Kakar, Tsung-Teh Wu, Matthew M Yeh, Michael S Torbenson, Zongming Eric Chen
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Abstract

Subtyping hepatic adenomas is important for patient management due to differing complication risks. Immunohistochemical staining with C-reactive protein (CRP) and serum amyloid-A (SAA) is widely accepted as a surrogate for molecular classification to identify inflammatory hepatocellular adenomas. Limited data, however, has been published on how these 2 stains compare for sensitivity. We conducted a large, multicenter, retrospective study to examine the sensitivity and staining characteristics of CRP and SAA in inflammatory hepatic adenomas, with focal nodular hyperplasia (FNHs) as a control group. Inflammatory adenomas were identified in 133 patients (average age 37 years, 109 were female). In all, 69.9% of cases were resection specimens and 90.2% of all cases showed positive staining for both CRP and SAA; 10 (7.5%) were positive for CRP only and 3 (2.3%) were positive for SAA only. CRP was more sensitive than SAA (97.74% vs. 92.48%, P -value = 0.0961) and showed more extensive and intense staining, with a significantly higher modified H-score ( P <0.001). Focal nodular hyperplasia can also show positive CRP and SAA staining but with a lower modified H-score ( P <0.0001). Based on beta-catenin and glutamine synthetase staining, 26 of inflammatory adenomas also had beta-catenin activation (19.5%). All 3 cases with positive SAA and negative CRP staining were beta-catenin activated. In contrast, the proportion of cases that were CRP positive and SAA negative was similar regardless of beta-catenin activation. The data affirms the strategy of using both CRP and SAA immunostains for hepatic adenoma subtyping and raises the awareness of the highly variable nature of SAA staining characteristics.

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CRP与SAA在炎症性肝腺瘤鉴别中的比较。
由于并发症风险不同,肝腺瘤亚型对患者管理很重要。C反应蛋白(CRP)和血清淀粉样蛋白-A(SAA)的免疫组织化学染色被广泛接受为识别炎症性肝细胞腺瘤的分子分类的替代品。然而,关于这两种污渍的敏感性比较数据有限。我们进行了一项大型、多中心、回顾性研究,以局灶性结节性增生(FNHs)为对照组,检查炎症性肝腺瘤中CRP和SAA的敏感性和染色特征。在133名患者中发现了炎症性腺瘤(平均年龄37岁,109人为女性)。总的来说,69.9%的病例是切除标本,90.2%的病例显示CRP和SAA阳性;10例(7.5%)仅CRP阳性,3例(2.3%)仅SAA阳性。CRP比SAA更敏感(97.74%对92.48%,P值=0.0961),并且显示出更广泛和更强烈的染色,具有显著更高的修饰H核(P
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来源期刊
Applied Immunohistochemistry & Molecular Morphology
Applied Immunohistochemistry & Molecular Morphology ANATOMY & MORPHOLOGY-MEDICAL LABORATORY TECHNOLOGY
CiteScore
3.20
自引率
0.00%
发文量
153
期刊介绍: ​Applied Immunohistochemistry & Molecular Morphology covers newly developed identification and detection technologies, and their applications in research and diagnosis for the applied immunohistochemist & molecular Morphologist. Official Journal of the International Society for Immunohistochemisty and Molecular Morphology​.
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