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Diagnostic Pathology
Published in: Diagnostic Pathology 1/2012

Open Access 01-12-2012 | Research

Enhancer of zeste homologue 2 (EZH2) is a reliable immunohistochemical marker to differentiate malignant and benign hepatic tumors

Authors: Szofia Hajósi-Kalcakosz, Katalin Dezső, Edina Bugyik, Csaba Bödör, Sándor Paku, Zoltán Pávai, Judit Halász, Krisztina Schlachter, Zsuzsa Schaff, Péter Nagy

Published in: Diagnostic Pathology | Issue 1/2012

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Abstract

Background

The immunohistochemical demonstration of Enhancer of zeste homologue 2 (EZH2) proved to be a useful marker in several tumor types. It has been described to distinguish reliably hepatocellular carcinomas from liver adenomas and other benign hepatocellular lesions. However, no other types of malignant liver tumors were studied so far.

Methods

To evaluate the diagnostic value of this protein in hepatic tumors we have investigated the presence of EZH2 by immunohistochemistry in hepatocellular carcinomas and other common hepatic tumors.
EZH2 expression was examined in 44 hepatocellular carcinomas, 23 cholangiocarcinomas, 31 hepatoblastomas, 16 other childhood tumor types (rhabdomyosarcoma, neuroblastoma, Wilms’ tumor and rhabdoid tumor), 17 metastatic liver tumors 24 hepatocellular adenomas, 15 high grade dysplastic nodules, 3 biliary cystadenomas, 3 biliary hamartomas and 3 Caroli’s diseases.

Results

Most of the malignant liver tumors were positive for EZH2, but neither of the adenomas, cirrhotic/dysplastic nodules, reactive and hamartomatous biliary ductules stained positively.

Conclusions

Our immunostainings confirm that EZH2 is a sensitive marker of hepatocellular carcinoma, but its specificity is very low, since almost all the investigated malignant liver tumors were positive regardless of their histogenesis. Based on these results EZH2 is a sensitive marker of malignancy in hepatic tumors. In routine surgical pathology EZH2 could be most helpful to diagnose cholangiocarcinomas, because as far as we know this is the first marker to distinguish transformed and reactive biliary structures. Although hepatoblastomas also express EZH2, the diagnostic significance of this observation seems to be quite limited whereas, the structurally similar, other blastic childhood tumors are also positive.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1173195902735693
Appendix
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Metadata
Title
Enhancer of zeste homologue 2 (EZH2) is a reliable immunohistochemical marker to differentiate malignant and benign hepatic tumors
Authors
Szofia Hajósi-Kalcakosz
Katalin Dezső
Edina Bugyik
Csaba Bödör
Sándor Paku
Zoltán Pávai
Judit Halász
Krisztina Schlachter
Zsuzsa Schaff
Péter Nagy
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Diagnostic Pathology / Issue 1/2012
Electronic ISSN: 1746-1596
DOI
https://doi.org/10.1186/1746-1596-7-86

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