Cd34 Immunostaining Adds Specificity To Microvascular invasion Analysis in Hepatocellular Carcinoma

Figures & data

Figure 1 Examples of vascular invasion by HCC in thin-walled vessels stained by (A and B) HE, and (C and D) CD34 IHC methods. We observe vascular vessels lined by endothelium containing neoplastic emboli.

Figure 2 Agreement of vascular invasion in HE and CD34 according to each observer in two different occasions.

Abbreviations: ExamA, examiner A; ExamB, examiner B; ExamC, examiner C.

Table 1 Intraobserver Agreement for 3 Examiners at 2 Different Moments, Regarding Vascular Invasion in HCC

Methods/Examiner	Kappa value (K)	Agreement	p-value	CI 95%
HE
Examiner A	0.837	Almost perfect	<0.0001	0.61–1.06
Examiner B	0.546	Moderate	<0.0001	0.32–0.77
Examiner C	0.682	Substantial	<0.0001	0.46–0.91
CD34
Examiner A	0.636	Substantial	<0.0001	0.41–0.86
Examiner B	0.629	Substantial	<0.0001	0.4–0.85
Examiner C	0.972	Almost perfect	<0.0001	0.75–1.2

Abbreviation: CI, Confidential interval.

Table 2 Interobserver Agreement for 3 Examiners at 2 Different Moments, Regarding Vascular Invasion

Methods/Moments	Kappa Value (K)	Agreement	p-value	CI 95%
HE
1st Moment	0.485	Moderate	<0.0001	0.36–0.61
2nd Moment	0.32	Fair	<0.0001	0.19–0.45
CD34
1st Moment	0.234	Fair	<0.0001	0.10–0.36
2nd Moment	0.218	Fair	0.001	0.09–0.35

Abbreviation: CI, Confidential interval.

Figure 3 (A) Intraobserver analysis of the accuracy of the association between the HE (standard) and immunohistochemical (CD34) methods by ROC curves. (A1) Examiner A, 1st moment; (A2) Examiner A, 2nd moment; (B1) Examiner B, 1st moment; (B2) Examiner B, 2nd moment; (C1) Examiner C, 1st moment; (C2) Examiner C, 2nd moment. (B) Interobserver analysis of the accuracy of the association between the HE (standard) and immunohistochemical (CD34) methods by ROC curves. A: 1st moment; B: 2nd moment.