The journal of medical investigation : JMI · 2026
CAM5.2 immunostaining visualizes hemodynamic-driven ductular-like differentiation in the liver:a practical marker for distinguishing circulatory disturbance-related hyperplastic lesions from hepatocellular tumors.
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Miyakami Yuko, Shao Wenhua, Ichimura-Shimizu Mayuko, Ogawa Hirohisa, Nakanishi Yuko, Tsuneyama Koichi
Аннотация
BACKGROUND AND AIMS: Focal nodular hyperplasia (FNH) is thought to arise from intrahepatic circulatory disturbances, but its distinction from hepatocellular carcinoma (HCC) and hepatocellular adenoma (HCA) remains challenging, especially in lesions with minimal cytological atypia. CAM5.2 is widely available in routine pathology laboratories, yet its diagnostic significance in hepatic lesions is unclear. We investigated whether CAM5.2 immunostaining visualizes hemodynamic-driven phenotypic changes of hepatocytes and whether its spatial pattern is informative.
METHODS: CAM5.2 immunohistochemical staining was analyzed in surgically resected specimens of FNH, HCA (HNF1α-inactivated and inflammatory subtypes), and HCC. The localization, distribution, and spatial regularity of CAM5.2 expression in hepatocytes and bile duct structures were evaluated and correlated with histological features of vascular remodeling.
RESULTS: In FNH, CAM5.2 showed a regular staining pattern confined to nodules and aligned along fibrous septa or abnormal vessels, highlighting ductular structures and adjacent hepatocytes. This pattern was absent in background liver parenchyma. In contrast, hepatocellular tumors showed irregular patterns:HNF1α-inactivated HCA exhibited weak focal positivity, inflammatory HCA diffuse staining, and HCC heterogeneous, patchy, or negative staining.
CONCLUSIONS: CAM5.2 visualizes hemodynamic-driven, ductular reaction-like phenotypic modulation of hepatocytes. A regular spatial pattern supports circulatory disturbance-related hyperplastic lesions e.g., FNH and aids exclusion of HCC and HCA. J. Med. Invest. 73 : 234-240, February, 2026.
METHODS: CAM5.2 immunohistochemical staining was analyzed in surgically resected specimens of FNH, HCA (HNF1α-inactivated and inflammatory subtypes), and HCC. The localization, distribution, and spatial regularity of CAM5.2 expression in hepatocytes and bile duct structures were evaluated and correlated with histological features of vascular remodeling.
RESULTS: In FNH, CAM5.2 showed a regular staining pattern confined to nodules and aligned along fibrous septa or abnormal vessels, highlighting ductular structures and adjacent hepatocytes. This pattern was absent in background liver parenchyma. In contrast, hepatocellular tumors showed irregular patterns:HNF1α-inactivated HCA exhibited weak focal positivity, inflammatory HCA diffuse staining, and HCC heterogeneous, patchy, or negative staining.
CONCLUSIONS: CAM5.2 visualizes hemodynamic-driven, ductular reaction-like phenotypic modulation of hepatocytes. A regular spatial pattern supports circulatory disturbance-related hyperplastic lesions e.g., FNH and aids exclusion of HCC and HCA. J. Med. Invest. 73 : 234-240, February, 2026.