FINE-NEEDLE ASPIRATION BIOPSY OF HEPATOCELLULAR-CARCINOMA - VALUE OF IMMUNOCYTOCHEMICAL AND ULTRASTRUCTURAL STUDIES

Over three years, 365 fine needle aspiration biopsies (FNABs) of the l iver were performed at Ottawa Civic Hospital. Fifty-nine percent of th ese aspirates were positive for malignancy. A diagnosis of hepatocellu lar carcinoma (HCC) was made in 20 liver aspirates. The initial light microscopic diagnoses of HCC were confirmed by immunocytochemical and/ or electron microscopic (EM) studies in 16 aspirates. Canalicular patt ern of staining with antibody to carcinoembuyonic antigen (CEA), posit ive staining with anticytokerntin AE3 and negative staining with antic ytokeratin AE1 supported the diagnosis of HCC. Although alpha-fetoprot ein (AFP) expression is relatively specific for Hcc, it was positive i n only 44% of cases, and the staining was usually focal. EM study conf irmed the diagnosis of HCC in seven cases. Based on our findings and p ublished reports, toe use a diagnostic panel of antibodies to CEA, AFP and anticytokeratins AE1 and AE3, and/or EM study when there is a sug gestion of HCC cytologically or clinically.