The Significance of Galectin-3 Immunohistochemistry, Clinical Characteristics and Liver Imaging in Differentiating Intrahepatic Cholangiocarcinoma from Adenocarcinoma Liver Metastasis
Arunee Dechaphunkul MD*, Samornmas Kanngurn MD**, Chavaboon Dechsukhum MD**, Pramot Tanutit MD***, Uthai Khow-Ean MD****, Patrapim Sunpaweravong MD*
Affiliation : * Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand ** Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand *** Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand **** Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Objective : To identify differences of Galectin-3 (Gal-3) immunostaining, clinical profiles, and images in patients with
intrahepatic cholangiocarcinoma (IHC) and adenocarcinoma liver metastasis, and be able to recognize these parameters as
diagnostic tools for differentiating these two diseases.
Material and Method: Histological slides from patients with IHC and adenocarcinoma liver metastasis were reviewed.
Immunohistochemical staining for Gal-3, Cytokeratin-7 (CK-7), and Cytokeratin-20 (CK-20) was performed and the results
categorized. Moreover, clinical characteristics and liver images of the patients were reviewed.
Results : Eighty-two patients were evaluated, 31 IHC and 51 adenocarcinoma liver metastasis. Patients who strongly
expressed Gal-3 were positive for CK-7 and negative for CK-20. Finding showed that 86% of them were IHC whereas only
14% were in adenocarcinoma liver metastasis. All patients with liver images showing a single lesion, located at central site,
and having intrahepatic duct dilatation were IHC. On the other hand, 77% of patients with liver imaging showing multiple
liver masses, located at peripheral site and having no intrahepatic duct dilatation were adenocarcinoma liver metastasis
while only 23% were in IHC.
Conclusion : Adding Gal-3 to CK-7 and CK-20 immunohistochemistry has benefits to differentiate IHC from adenocarcinoma
liver metastasis. Furthermore, liver imaging profiles also give benefits for differentiating between these two diseases.
Keywords : Cholangiocarcinoma, Adenocarcinoma liver metastasis, Galectin-3, Immunohistochemistry, Clinical characteristics, Imaging
