Novel strategy to diagnose and grade hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is among the most common malignancies worldwide, particularly in South and South East Asia. Unfortunately due to lack of appropriate facilities and awareness only limited information is available about its early diagnosis. Aim of the present study was to determine the efficacy of p53 by immunohistochemistry and Argyrophilicnucleolar organizer regions (AgNORs) in diagnosis of HCC and cirrhosis of liver. A total of 100 liver biopsies were studied, it included 20 cases of HCC, 60 cases of cirrhosis of the liver and 20 cases of normal liver from autopsy specimens as a control. Out of 20 cases of HCC, 15 were positive for p53 stain and 5 were negative. None of the 60 cases of cirrhosis or 20 with normal histology revealed p53 expression. A statistically significant (p < 0.001) difference was observed between mean AgNOR counts of normal (1.57 +/− 0.13), cirrhotic (4.70 +/− 0.66) and HCC tissues (14.96 +/− 1.18). In contrast the mean AgNOR count of biopsies with alcoholic cirrhosis (1.57 +/− 1.62) was significantly less (p < 0.001) than post-hepatitic cirrhosis and was similar to that of normal liver tissue. AgNORs differentiates post-hepatitic and alcoholic cirrhosis. HCV and HBV were found to be the main causative agents in HCC and Cirrhosis of liver. Mean age of HCC patients was slightly higher than liver cirrhosis patients. It is concluded that p53 and AgNORs can act as a good adjuvant to histology in diagnosing liver diseases. It helps in differentiation from well differentiated to moderately and to poorly differentiated HCC.