ORIGINAL ARTICLE: Expression pattern of glypican‐3, HSP70, and glutamine synthetase in chronic hepatitis B and hepatocellular carcinoma

ABSTRACT Background and aim: The three‐panel marker, glypican‐3, HSP70 and glutamine synthetase, is helpful for making a diagnosis of early hepatocellular carcinoma. To further characterize the diagnostic values of these three markers, we performed immunostaining studies in non‐neoplastic hepatocytes (chronic hepatitis B) and hepatocellular carcinoma. Methods: Immunostaining was performed for all three markers. The cases were 60 needle biopsies of chronic hepatitis B (30 with low‐grade activity and 30 with high‐grade activity) and 40 hepatocellular carcinomas (HCCs). Results: Glypican‐3 staining was detected in only one of the 60 chronic hepatitis B cases, and this case expressed moderate immunoreactivity for glypican‐3 and showed high‐grade inflammatory activity. HSP70 expression was not observed in any cases. Glutamine synthetase was strongly immunoreactive at peri‐venular hepatocytes with cytoplasmic staining in all cases. These findings reflected a normal expression pattern. On the other hand, all three markers were positive in 15 (37.5%) HCCs. At least two of three markers were positive in 26 (65.0%). Moreover, all three markers were negative in 2 (5.0%) HCCs. Conclusions: The combination of these three markers is highly specific for detecting hepatocellular carcinoma. However, caution should be exercised because non‐neoplastic hepatocytes in chronic hepatitis B with high necro‐inflammatory activity tend to show focal positivity for glypican‐3. Also we emphasize that all three markers can show negative immunoreactivity in HCC.