Abstract: Objective To evaluate combined application of glypican-3 and cytokeratin-19 in diagnosis and differential diagnosis of hepatocellular carcinoma(HCC). Methods Totally 142 cases of HCC were chosen in our hospital from Dec. 2009 to Mar. 2011. Among these patients, 94 had HCC, 32 had intrahepatic cholangiocarcinoma(ICC), 16 had combined hepatocellular and cholangiocarcinoma(CHC). Adoptive HE, glypican-(GPC-3) and cytokeratin-19(CK-19) immunohistochemical-staining was performed, and the results of GPC-3 were compared with those of CK-19 in the three groups in expression and distribution in HCC, ICC, and CHC. Results Positive result of GPC-3 was found in 79 cases(84%) with HCC, 5 cases(15.6%) with ICC, and 16 cases(100%) with CHC. Immunostaining for CK-19 was negative in all HCC cases, while it was positive in 31cases(97%) with ICC, and in 16 cases(100%) with CHC. Staining intensity and positive rate of GPC-3 in the moderately/poorly differentiated groups of HCC cases was higher than that in the well differentiated group. Staining intensity was related to the extent of differentiation(P<0.001). Conclusion Expression of GPC-3 had high degree of specificity and sensibility in HCC and CHC cases. Combined application of GPC-3 and CK-19 may have important diagnostic value in distinguishing HCC from ICC and CHC.

Key words: oncoma, hepatocellular carcinoma, intrahepatic cholangiocarcinoma, immunohistochemistry, glypican-3, cytokeratin-19