الفهرس 
Introduction and Aim of the Work
Overview on normal structure of the liverOnly 14 pages are availabe for public view
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Abstract
The present work was done on a total of 56 cases diagnosed as primary carcinoma and metastatic AC in the liver at National Cancer Institute, Cairo University with 20 HCCs, 5 CCs and 31 metastatic ACs from various primary origins. The majority of our cases were males and the mean age for all study group cases was 54.04 years ± 12.7 SD. All cases were subjected to H&E histopathological examination and immunohistochemical staining for MOC-31, Hep Par 1, N-cadherin and CK7 using Avidin- Biotin immunoperoxidase technique.
The sensitivity of MOC-31 for AC in the study group was 97.2% while its specificity was 90%. The sensitivity of Hep Par 1 for HCC in the study group was 75% while its specificity was 100%. The sensitivity of N-cadherin for primary liver carcinoma in the study group was 72% while its specificity was 83.9%. The sensitivity of CK7 for CC in the study group was 100% while its specificity was 58.8%.
A significant correlation was detected in this study between Hep Par 1 immunostaining and tumor grade in HCC cases (p value = 0.04) with loss of positivity in high grade tumors. No significant correlation was noticed between any other antibody and tumor grade in HCC in our study group.
The most helpful combination of two antibodies was the combination of MOC-31 with Hep Par 1 diagnosing 50/56 (89.3%) of cases. Cases which were positive to MOC-31 and negative to Hep Par 1 were more likely to be AC (CC or metastatic AC) with a high statistical significance. Cases which were positive to Hep Par 1 and negative to MOC-31 were more likely to be HCC with a high statistical significance.
The most helpful combination of three antibodies was the combination of Hep Par 1 with both MOC-31 and N-cadherin diagnosing 52/56 (92.9%) of cases. Cases which were positive to MOC-31 and negative to both Hep Par 1 and N-cadherin were more likely to be metastatic AC with a high statistical significance while cases which were negative to MOC-31and positive to both Hep Par 1 and N-cadherin were more likely to be HCC with a high statistical significance. Cases which were positive to both MOC-31 and N-cadherin and negative to Hep Par 1 were more likely to be CC with a statistical significance.
The panel of the four antibodies (MOC-31, Hep Par 1, N-cadherin and CK7) was useful in our study diagnosing 53/56 (94.6%) of cases. Cases which were positive to both Hep Par 1 and N-cadherin and negative to both MOC-31 and CK7 were more likely to be HCC with a high statistical significance. Cases which were negative to Hep Par 1 and positive to all other three antibodies were more likely to be CC with a statistical significance. Cases which were negative to both Hep Par 1 and N-cadherin and positive to MOC-31 only or both MOC-31 and CK7 were more likely to be metastatic AC with a statistical significance.