Glypican-3 and Hep Par-1 are Useful Biomarkers in the Cytologic Assessment of Ascites.

Till date, the utility of cytologic assessment of ascites for the identification of hepatocellular carcinoma (HCC) cells is still debated and the usefulness of immunocytochemistry for glypican-3 (GPC3) and Hep Par-1 in this setting has not been reported. Liquid-based cytology of ascitic fluid of 28 cirrhotic patients was performed and the spots obtained were stained with hematoxylin and eosin, papanicolau, and with GPC3 and Hep Par-1 antibodies. GPC3 and Hep Par-1 antibodies stained positively the atypical cells in the ascites of 2 patients with HCC showing an exophytic growth pattern. The specimens of the patients with nonexophytic HCC, other non-HCC cancers, or cirrhosis stained negatively. We hypothesize a relationship with the exophytic growth of the tumor. Thus, GPC3 and Hep Par-1 are useful in the cytologic assessment of peritoneal effusions to distinguish mesothelial cells and neoplastic non-HCC cells from HCC cells, presence of which, however, represent a very rare event. This is the first study in which GPC3 and Hep Par-1 immunostaining has been used in the cytologic assessment of HCC ascites.