Role of immunohistochemistry in differentiating primary hepatocellular carcinoma using manual tissue microarray technique and its advantage

Hepatocellular carcinoma (HCC) is a leading cause of liver cancer worldwide, posing diagnostic and therapeutic challenges, particularly in distinguishing it from metastatic liver tumors. This study evaluates the role of tissue microarray (TMA) technology and immunohistochemical markers, specifically Hep Par-1 and alpha-fetoprotein (AFP), in the differentiation and characterization of HCC.Thirty cases of HCC were analyzed, including 11 well-differentiated, 3 moderately differentiated, and 16 poorly differentiated tumors. TMA construction was performed, and immunohistochemistry was conducted to assess Hep Par-1 and AFP expression. Hep Par-1 demonstrated granular cytoplasmic positivity, with a sensitivity of 80% and specificity of 100%. Reactivity decreased with poorer differentiation, as all six negative cases were poorly differentiated. AFP positivity was observed in 45% of cases, with no significant correlation to differentiation level.Age distribution revealed a peak incidence between 31 and 70 years, with a male predominance (60%). Comparative analyses with previous studies confirmed consistent epidemiological trends and highlighted the diagnostic challenges in poorly differentiated HCC.The findings reaffirm Hep Par-1 as a reliable marker for HCC diagnosis, particularly in well-differentiated cases. AFP was less reliable due to variability in expression. The use of TMAs enhanced efficiency and reduced costs, supporting their utility in histopathological research. These results underscore the importance of combining morphological, immunohistochemical, and clinical data for accurate HCC diagnosis and management.