568 A NOVEL PROGNOSTIC ESTIMATION FORMULA FOR HEPATOCELLULAR CARCINOMA AFTER RESECTION, BASED ON TNM STAGING, TOTAL BILIRUBIN LEVEL, BLOOD LOSS, HLA-DR ALPHA AND DNA METHYLTRANSFERASE 1

Abstract

Introduction: Hepatocellular carcinoma (HCC) is the third most common reason for cancer-related death worldwide. According to EASL guidelines HCC can be diagnosed by imaging studies and pathological evaluation of tissue biopsies. However, in some cases pathological examination is very difficult and further studies are need for the exact diagnosis of HCC. In the past, we have described that an increase in chromosomal instability observed by FISH analysis during dedifferentiation of HCC. The aim of this study was to evaluate of FISH analysis can be used as a routine procedure for the diagnosis of HCC in combination with conventional pathological examination. Methods: Tissue biopsies from a total of 63 patients with new intra-hepatic lesions were biopsied and by conventional pathology and fluorescence in situ hybridization (FISH). FISH was performed, using a set of probes specific for the centromeres of chromosomes 1 and 8. Results from both pathological analysis and FISH analysis were compared with clinical outcome of patients in order to verify the correctness of diagnosis. Results: In this retrospective analysis only patients were included, who presented at our institution and for whom, a pathological report, a FISH analysis and the clinical course for a minimum of 18 months was available. In 42/63 cases clinical outcome correlated with both pathology report and FISH analysis. In 2 cases FISH analysis as well as pathology report were negative despite of a positive clinical outcome. In 3/63 cases FISH analysis but not the pathology report were suggestive for HCC, while the clinical outcome was positive and in 14/63 cases pathology report was positive but FISH analysis was negative while the clinical outcome was suggestive for HCC. Finally in 1/63 cases either pathology report or FISH report were suggestive for HCC, while the clinical outcome was negative. Conclusion: This retrospective analysis suggests that FISH analysis can help analyzing biopsies from patients with intra-hepatic lesions suspicious for HCC. However negative results cannot rule out the presence of HCC.