ECP 2023 Abstracts

S13 Virchows Archiv (2023) 483 (Suppl 1):S1–S391 13 KP. Clinical information about attacks of cholangitis, native-liver survival, need for transplantation were obtained from the database. Results: Among the 26 cases, 23 had Kasai in 90 days after birth, involved in the statistical analysis. 8 (%34.8) cases were operated in the first 45 days (Group 1) whereas 15 (Group 2) between 45-90 days. Severe fibrosis was significantly more common in Group 2(p=0,009). Biliary duct proliferation was more commonly intense(p=0,008) and diffuse(p=0,032) in Group 2. There was no significant differ- ence between groups for GTC. Additionally, no difference was found between the groups in terms of clinical outcomes. However, patients with shorter than two-years native-liver survival(n=6) were all in Group 2. Besides, patients with at least four years native-liver survival had had Kasai before 60 days. Conclusion: BA is, by its nature, a progressive disease that results in liver cirrhosis. It has been demonstrated by clinical outcomes and patho- logical parameters that surgery performed at an early age offers a longer native-liver survival. It is seen that findings from pathological examina- tion are directly related to time until KP is performed, these findings can provide preliminary information about the course of the disease. OFP-03-009 Correlations between morphology and mutational profile in hepa- tocellular carcinoma: time for routine molecular biology? S. Chillotti*, T. Maloberti, G. Germinario, M. Carroli, M. Ravaioli, D. de Biase, A. D’Errico, F. Vasuri *Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bolo- gna, Bologna, Italy., School of Anatomic Pathology, Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy Background & objectives: The mutational profiling could be a useful tool to better stratify risk in patients with hepatocellular carcinoma (HCC). Our aim is to evaluate how and if next-generation sequencing (NGS) results, immunohistochemistry (IHC) and morphology correlate each other. Methods: We enrolled 76 consecutive resected HCCs on which we reviewed the histology and recorded various morphological parameters such as grade, architecture, variant, presence of overt cirrhosis and microvascular invasion. We then performed NGS with a panel spanning 330 amplicons and IHC analysis for the proteins p53, beta-catenin and glutamine synthase (GS). Results: The most commonly found mutations were TERT-promoter (61%), TP53(32%) and CTNNB1(28%). Less frequent mutations were found: SMAD; KIT; PI3K and IDH1. TP53-mut correlated with higher grade tumours (p=0.029), and with macrotrabecular/solid architecture(p=0.004) while TERT-mut was found in 50% of non- cirrhotic cases and 72% of cirrhotic cases (p=0.040). CTNNB1 didn’t correlate with a specific pattern. IHC for p53 was not useful in recogniz- ing TP53-mut. IHC for GS was strongly and diffusely positive only in CTNNB1-mut cases, but with 3 negative cases. Beta-catenin expression in non-CTNNB1-mut cases was strong membranous while in CTNNB1- mut cases it showed a variable staining with 10 showing a nuclear trans- location, 17 cytoplasmic positivity and 14 lost the membrane positivity. Conclusion: Our results show a variegated mutational landscape: TP53-mut correlates with histological appearance, but in absence of a clear IHC positivity. CTNNB1-mut cases were recognizable using beta- catenin and GS: GS positivity is today used as a diagnostic tool in early HCCs, but as we showed it can be negative also in CTNNB1-mutated cases. Considering that we found HCCs with potentially targetable mutations but lacking specific morphology, it could be time to include NGS in the routine practice of HCCs. Funding: Fondazione Cassa di Risparmio in Bologna OFP-03-010 Keratin filaments deficiency in ischemia-reperfusion liver injury T.S. Driva*, A. Pergaris, G. Sotiropoulos, E. Antoniou, I. Delladet- sima, S. Sakellariou *1st Department of Pathology, General Hospital of Athens “Laiko”, Medical School, National and Kapodistrian University of Athens, Greece Background & objectives: Keratin (K) 7 is expressed by hepatocytes in ischemic states, while attenuation of K8/18 expression has been observed in ballooned hepatocytes in various liver diseases. Herein we investigate the expression of K8/18 and K7 in ballooned hepatocytes of ischemia/reperfusion injury. Methods: K7 and K8/18 expression was immunohistochemically assessed and semiquantitatively evaluated in 8 graft biopsies with ischemia /reperfusion injury showing minimal/mild (3 cases) to moder- ate/severe (5 cases) degree of hepatocellular ballooning and cholestasis (6 cases). Liver samples were obtained 1 to 9 days post-transplantation. Results: A significant reduction to elimination of the cytoplasmic expression of K8/18 was observed in ballooned hepatocytes in the cases with prominent hepatocellular ballooning in zones 3 and 2. Slight attenuation and occasionally loss were demonstrated in those with milder cell swelling. Hepatocellular expression of K7 was observed in zone 3 only in 2 cases with minimal hepatocellular ballooning. Conclusion: In ischemia/reperfusion injury hepatocellular balloon- ing is associated with disorders of keratin filaments 8/18. Attenuation and loss of their cytoplasmic expression are related to the degree of ballooning. Lack of K7 appearance in hepatocytes with prominent bal- looning suggests generalized intermediate keratin filaments disarray or arrest of liver cell metaplastic mechanisms, while an independent to ischemia pathogenetic process cannot be excluded. OFP-03-011 Hepatic histopathological lesions and study of liver stiffness in a case series of patients with Fontan procedure M.R. Meléndez Gispert*, L. Téllez, C. Ariño-Palao, D. Bueno- Sacristán, A. Tenelanda-Santillán, A. Veliz Dominguez, C. Perna Monroy *Ramón y Cajal University Hospital, Spain Background & objectives: Fontan procedure (FP) is performed in single ventricle defects patients and produces long-term liver dam- age. Liver stiffness, several grades of fibrosis and even hepatocellular carcinoma (HCC) may occur. Time from surgery is an important issue. Methods: Liver biopsies and clinical data including transient elastogra- phy (FibroScan®) from patients with FP were reviewed between 2017 and 2023. The hepatic congestive fibrosis index was used to classify fibrosis into F0, F1, F2A, F2B, F3 and F4. Results: Fifty-nine patients, 38 males (64.40%) and 21 females (35.59%) were found. Mean age was 30.79 years. Patients were cat- egorized into F0 (1.69%), F1 (8.47%), F2A (20.33%), F2B (8.47%), F3 (32.2%) and F4 (28.81%). Elapsed time from surgery in these groups were 20, 21.2, 22.83, 20.8, 23.31 and 25.35 years respectively. Four patients (6.77%) developed HCC (3,38% F4, 1,69% F2A). The mean value of liver stiffness was 17.5 KPa in F0, 20.26 KPa in F1, 26.43 KPa in F2A, 15.40 KPa in F2B, 23.77 KPa in F3 and 40.38 KPa in F4. Conclusion: Nearly 90% of biopsies disclosed significant hepatic fibrosis (≥F2) which confirms that fibrosis is practically universal in FP patients. A common potential complication of chronic liver damage is the develop- ment of HCC. All patients except three, presented severe liver stiffness val- ues on FibroScan®(≥F3). F4 patients showed marked increase in stiffness compared with F2 and F3 patients. Non-invasive methods of monitoring liver fibrosis are usually used in FP patients. However, only congestive fibrosis index in biopsy remains validated as the gold standard. OFP-03-012 Expression of fibroblast activation protein (FAP) in pancreatic neuroendocrine tumours F. Kellers*, V. Stoll, C. Röcken, B. Konukiewitz