Discovery and clinical significance of 1p36 chromosomal aberrations in differentiating hepatocellular carcinoma from other hepatobiliary cancers

Differentiating among hepato-pancreato-biliary (HPB) cancers like cholangiocarcinoma (CCA), hepatocellular carcinoma (HCC), pancreatic cancer (PC), and gallbladder cancer (GBC) can be challenging. To address this, our study used fluorescence in situ hybridization (FISH) to identify 1p36 chromosomal abnormality patterns in 100 HPB cancer patients. We found consistent 1p36 loss in CCA, IPNB, GBC, and PC, while HCC uniquely exhibited normal, loss, and gain patterns. Notably, this 1p36 gain showed a sensitivity was 45.71 % and specificity was 100 % for differentiating HCC from CCA and other HPB cancers, while 1p36 loss proved highly sensitive (100 %) and specific (85.71 %) for distinguishing CCA from HCC, though its ability to differentiate CCA from others was limited. Beyond diagnosis, a high burden of 1p36 loss was a significant prognostic factor for shorter overall survival in CCA (p = 0.024) and in the combined CCA/IPNB cohort (p = 0.015). More importantly, 1p36 loss also significantly correlated with tumor differentiation in CCA (p < 0.05). These results suggest that assessment of 1p36 status by FISH may serve as a complementary molecular approach to conventional histopathology and immunohistochemistry, providing additional differential diagnostic HCC from CCA and other diagnostically challenging HPB cancers and serve as promising prognostic biomarkers for CCA and IPNB.