Differential Diagnosis Between Hepatic Focal Nodular Hyperplasia(FNH) And Hepatocellular Carcinoma With Negative Alpha Fetal Protein

Background and Objective: Hepatic focal nodular byperplasia(FNH) is the second most frequent benign liver tumor to hemangiomas in benign liver tumors.It reresents13.8%of all liver benign tumors and1.1%of all liver tumors. Hepatocellular Carcinoma is one kind of the most common malignant tumors worldwild,though it can be screening by Alpha fetal protein now,but30%of them is positive. Though it is easy to distinguish FNH from hepatocellular carcinoma with positive Alpha fetal protein,but the differential diagnosis between FNH and hepatocellular carcinoma with negative Alpha fetal protein is difficult.The study was designed to study the differential diagnosis between hepatic focal nodular hyperplasia(FNH)and hepatocellular carcinoma with negative Alpha fetal protein through imaging and pathology.Methods:To analyse retrospectively the clinical,imaging and pathology materials of16patients with FNH and80patients with AFP negative hepatocellular carcinoma proven by operation and pathology during January2004to December2010in the Affiliated Hospital of Qingdao University Medical College. Immunohistochemistry was used to analyse the difference between FNH and AFP negative hepatocellular carcinoma by four facts:CD34, PCNA, CK19and S-100.Results: In dynamic enhanced CT,there are the performances of "fast in and slow out"in FNH and "fast in and fast out"in AFP negative hepatocellular carcinoma. After immunohistochemistry, CD34can concentrate express in vascular endothelial cell of central scar and fiber spacing in FNH, diffuse express in AFP negative hepatocellular carcinoma.PCNA can diffuse express in FNH and AFP negative hepatocellular carcinoma,but its expression is increased in AFP negative hepatocellular carcinoma.Conclusion:FNH shows some typical clinical.It is feasible to be differentiated from AFP negative hepatocellular carcinoma in all kinds of inspection method. PCNA and CD34can become the identify index between FNH and AFP negative hepatocellular carcinoma after immunohistochemistry.