ĐẶC ĐIỂM MÔ BỆNH HỌC UNG THƯ BIỂU MÔ TẾ BÀO GAN VÀ ĐÁNH GIÁ CK19 TRONG UNG THƯ BIỂU MÔ TẾ BÀO GAN

Abstract

Objective: To describe the histopathological features of hepatocellular carcinoma (UTBMTBG) according to the 2019 WHO classification and evaluate the expression of CK19 – a hepatic progenitor marker – in relation to histological prognostic factors. Patients and Methods: A retrospective descriptive-analytical study was conducted on 182 cases of surgically resected HCC at Bach Mai Hospital (2020–2022). CK19 expression was assessed by immunohistochemistry (IHC), and histopathological parameters were examined microscopically and compared with adverse prognostic features. Results: The predominant histological subtype was the conventional type (56.0%), with a majority showing mixed architecture (51.1%), high mitotic activity (67.6%), and microvascular invasion (37.9%). CK19 positivity was observed in 49 cases (26.9%), including 29 focal (15.9%) and 20 diffuse (11.0%) patterns. CK19 expression was significantly associated with high mitotic index (p = 0.0002), tumor necrosis (p = 0.0228), microvascular invasion (p = 0.0021), and marked inflammatory infiltration (p = 0.0001), and was more frequent in rare histological subtypes such as the scirrhous (83.3%) and lymphocyte-rich (75.0%) types. The diffuse CK19 expression group tended to show more aggressive histological features than the focal or negative groups.. Conclusion: CK19 expression in HCC is closely associated with adverse histological prognostic features, highlighting its potential role in risk stratification and personalized treatment planning.