Clinicopathologic features of poorly differentiated hepatocellular carcinoma
Clinicopathologic features of poorly differentiated hepatocellular carcinoma
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DOI：
10.1002/jso.20661
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发表时间：
2007-03-15
影响因子：
2.5
通讯作者：
Asahara, Toshimasa
中科院分区：
文献类型：
--
作者：
Oishi, Koichi;Itamoto, Toshiyuki;Asahara, Toshimasa
背景和目的：低分化肝细胞癌（HCC）的临床病理特征尚未阐明。本研究的目的是阐明低分化肝癌的特点hepatectomized patients.Methods：从1986年至2001年，354例肝癌患者进行了根治性肝切除术在我们的机构，并进行了前瞻性随访。组织学检查显示43例高分化HCC肿瘤，273例中分化HCC肿瘤和38例低分化HCC肿瘤。结果：术前低分化肝癌组与中分化肝癌组仅血清甲胎蛋白水平差异有统计学意义（P = 0.0001）。虽然三组的总生存率或无病生存率之间没有显著差异，但肝切除术后2年内远处转移发生率在低分化肝癌组（21%）高于高分化肝癌组（2%）（P=0.011）或中分化肝癌组（8%）（P=0.018）。肿瘤直径大于3cm的低分化肝癌组中约有40%的患者发生远处转移。结论：肿瘤直径大于3cm的低分化肝癌患者在肝切除术后的早期即已发生远处转移。
Background and Objectives: Clinicopathologic features of poorly differentiated hepatocellular carcinoma (HCC) have not been elucidated. The purpose of this study was to clarify the characteristics of poorly differentiated HCC in hepatectomized patients.Methods: From 1986 to 2001, 354 HCC patients underwent curative hepatectomy in our institution and were prospectively followed. Histological examinations revealed 43 well-differentiated HCC tumors, 273 moderately differentiated HCC tumors, and 38 poorly differentiated HCC tumors. Clinicopathologic factors and outcomes after hepatectomy were compared statistically.Results: Only serum alpha-fetoprotein level was significantly different in the poorly differentiated HCC group from that in the moderately differentiated HCC group preoperatively (P = 0.0001). Although there were no significant differences between overall survival rates or between disease-free survival rates in the three groups, distant metastasis within 2 years after hepatectomy occurred more frequently in the poorly differentiated HCC group (21%) than in the well-differentiated HCC group (2%) (P=0.011) or moderately differentiated HCC group (8%) (P=0.018). Distant metastasis occurred in about 40% of patients in the poorly differentiated HCC group with tumor size greater than 3 cm.Conclusions: Poorly differentiated HCC tumors larger than 3 cm are already of advanced stage representing distant metastasis in the early period after hepatectomy.