Diagnostic markers in hepatocellular carcinoma using immunohistochemical techniques

Hepatocellular carcinoma (HCC) is the seventh most common cancer in men and the ninth in women with an estimated incidence of about 1 million per year worldwide. HCC also accounts for 90% of all primary hepatic malignancies, and in most cases, appears to be a consequence of chronic infection of the liver by hepatotropic viruses (hepatitis B and hepatitis C viruses) (1). It is a highly malignant tumor with a poor prognosis that has been attributed to late diagnosis. Detection of HCC at an early stage may result in more effective treatment. However, the lack of symptoms in the early stage of the disease makes screening of patients at risk for HCC impractical. Surgical tumor resection or liver transplantation has been accepted as the only means of cure, but the postoperative recurrence within the remaining liver or even in the transplanted organ is also a cause of poor prognosis (2). It is therefore important to identify factors in tissues that can predict tumor recurrence and prognosis after resection in order to provide adjuvant therapy to different patient groups. It has recently been reported that proliferation rate and markers of cell loss, such as necrosis and apoptosis, may have prognostic value. Proliferation markers such as MIB-1 (Ki-67) and proliferating cell nuclear antigen (PCNA) have been studied in tumor specimens.