APOPTOSIS AND CYTOLOGIC DIFFERENTIATION IN HEPATOCELLULAR-CARCINOMA ON FINE-NEEDLE ASPIRATION SAMPLES

OBJECTIVE: To evaluate possible alterations of the mechanisms leading to apoptosis in hepatocellular carcinoma by studying bcl-2 expression on fine needle aspiration biopsy (FNAB) samples using immunocytochemis try. STUDY DESIGN: The study was performed on a series of 84 hepatocar cinomas aspirated under ultrasound guidance. A Papanicolaou-stained sm ear for each case was destained and restained by bcl-2 by using the im munoperoxidase technique. bcl-2 Expression was then correlated with cy tologic grading and the size of the tumor. RESULTS: In 16 cases (19%), bcl-2 immunostaining gave a specific cytoplasmic signal. Fourteen of these positive cases were well differentiated, and two were pleomorphi c tumors. Six positive cases were smaller than 5 cm, 3 were larger tha n 5 cm, and 7 were diffuse. CONCLUSION: A significant percentage of he patocellular carcinomas produce and accumulate bcl-2 protein in cell c ytoplasm. bcl-2 Expression can be detected on destained cytologic smea rs. bcl-2 Expression seems to correlate with the cytologic degree of d ifferentiation but not with the size of the tumor.