Back ground :The risk of hepatocellular carcinoma (HCC) development in chronic hepatitis C infection is increased in Egypt . Progenitor cells (oval cells) of the liver are activated by liver damage as that caused by virus infection resulting in its proliferation and differentiation into singular and/or ductular forms. Hepatic progenitor cells (HPCs) may be the target cells for carcinogenesis in HCC. Epithelial cell adhesion molecule (EpCAM) and Cytoketain 19(ck19) were known as hepatic progenitor stem cell markers
Aim of the study: To evaluate expression of EpCAM and CK19 in cases of chronic hepatitis, hepatic dysplasia and hepatocellular carcinoma. In addition to studying the relation between their expression and clinicopathological data.
Methods: A retrospective study was performed on paraffin sections of 81 specimens of liver tissues including 6 specimens of normal liver, 24 specimens of chronic hepatitis C and 51 specimens of HCC, 39 cases of non-tumor tissue adjacent to Hepatocellular (HCC) all sections subjected to: Hematoxylin and eosin stain for histopathological assessment to confirm diagnosis and immunohistochemical staining for evaluation of EpCAM and Ck19 expression
Results: All cases of studied normal group were negative for EpCAM and CK19 expression .Regarding to EpCAM in chronic hepatitis group: Four cases (16.7%) negative ,while 20 cases(83.3%) positive. In non tumor adjacent group :all cases(39) positive .In HCC group :18 cases (35.3%) of HCC were negative while 33 cases (64.7%) positive There was statistical significant relation between EpCAM with AFP level only, however there was no statistical significant relation with other clinicopathological data of other groups .Regarding Ck19 expression, There was statistical significant difference between +ve CK-19 hepatocytes in all groups as it is only present in HCC group (3.2±14.2) and between +ve CK19 cells with LPC morphology in all groups as the highest in non tumor adjacent group .There was statistical significant relation between CK19 expression in chronic hepatitis group with activity and fibrosis, while in HCC group with AFP level and grade.
Conclusion: The positive correlation between the number
of HPCs and the severity of chronic hepatitis indicates the
possible role of these cells in the development of HCC.
Positive CK19 staining in HCC indicates the presence of a
subtype of HCC with biliary differentiation and suggests its
HPC origin. CK19 can be considered as HCC prognostic
marker as it was expressed in all poorly differentiated HCC.
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