Cholestasis is a marker for hepatocellular carcinomas displaying β‐catenin mutations

V Audard, G Grimber, C Elie, B Radenen… - The Journal of …, 2007 - Wiley Online Library
V Audard, G Grimber, C Elie, B Radenen, A Audebourg, F Letourneur, O Soubrane
The Journal of Pathology: A Journal of the Pathological Society of …, 2007Wiley Online Library
The Wnt/β‐catenin signalling pathway is activated in many human hepatocellular
carcinomas (HCC). Identification of β‐catenin mutation relies mostly on sequence analysis
and/or immunohistochemistry. β‐catenin mutation may also be detected by analysing the
expression of its target genes. The GLUL gene encoding glutamine synthetase (GS), for
example, appears to be a pertinent marker. The aim of this study was to correlate GS
immunostaining and β‐catenin mutations with clinicopathological features in HCC. We …
Abstract
The Wnt/β‐catenin signalling pathway is activated in many human hepatocellular carcinomas (HCC). Identification of β‐catenin mutation relies mostly on sequence analysis and/or immunohistochemistry. β‐catenin mutation may also be detected by analysing the expression of its target genes. The GLUL gene encoding glutamine synthetase (GS), for example, appears to be a pertinent marker. The aim of this study was to correlate GS immunostaining and β‐catenin mutations with clinicopathological features in HCC. We found that GS immunostaining had a sensitivity of 90% for the detection of β‐catenin mutations, with 98% specificity, whereas β‐catenin immunostaining had a sensitivity of 63% with 98% specificity. We used the sensitive GS marker to characterize 190 HCC cases. Sixty‐eight (36%) cases displayed Wnt/β‐catenin activation. In addition to their well‐differentiated pattern, these tumours exhibited significant features such as a homogeneous microtrabeculo‐acinar pattern, low‐grade cellular atypia, and cholestasis. As these tumours exhibited cholestasis, we hypothesized that β‐catenin acts on specific bile synthesis and/or transport pathways. In conclusion, we propose that GS immunostaining and a cholestatic pattern are relevant criteria for the identification of HCC with β‐catenin mutations. Copyright © 2007 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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