Hepatocellular adenoma: Classification, variants and clinical relevance
Hepatocellular adenoma: Classification, variants and clinical relevance
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DOI：
10.1053/j.semdp.2016.12.007
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发表时间：
2017-03-01
影响因子：
2.3
通讯作者：
Balabaud, Charles
中科院分区：
文献类型：
--
作者：
Bioulac-Sage, Paulette;Sempoux, Christine;Balabaud, Charles
肝细胞腺瘤是一种良性肿瘤，有两个主要的并发症，出血和恶性转化。肝细胞腺瘤的总体叙述随着时间的推移而演变。暴露于口服避孕药的育龄妇女的正常肝脏中发生的孤立性或多发性肝细胞仍然是最常见的临床背景，然而，正在认识到新的关联。肝细胞腺瘤是在肝脏疾病如非酒精性脂肪性肝炎、血管疾病和酒精性肝硬化的背景下发现的。肝细胞腺瘤也报告在男性，年轻或老年人，甚至在婴儿。在形态分子方面，最大的飞跃是发现肝细胞腺瘤不是一个单一的实体，至少存在3种不同的亚型，具有特定的潜在基因突变。这些突变影响HNF 1A基因、导致JAK/STAT 3通路激活的几个基因和CTNNB 1基因。所有这些都与或多或少特定的组织病理学特征相关，并且可以使用免疫组织化学与特异性抗体或替代标记物进行识别。肝病理学家和放射学家是通过识别其特定的形态学特征来识别不同亚型肝细胞腺瘤的关键角色。肝细胞腺瘤分类的主要影响是识别恶性转化风险较高的受试者。随着新分子技术的发展，有希望更好地了解不同亚型的自然史，特别是它们的恶性转化机制。(C)2017由Elsevier Inc.出版
Hepatocellular adenomas are benign tumors with two major complications, bleeding and malignant transformation. The overall narrative of hepatocellular adenoma has evolved over time. Solitary or multiple hepatocellular developing in the normal liver of women of child bearing age exposed to oral contraceptives still represents the most frequent clinical context, however, new associations are being recognized. Hepatocellular adenoma is discovered on a background of liver diseases such as non-alcoholic steatohepatitis, vascular diseases, and alcoholic cirrhosis. Hepatocellular adenoma is also reported in men, young or older adults, and even in infants. On the morpho-molecular side, the great leap forward was the discovery that hepatocellular adenoma was not a single entity and that at least 3 different subtypes exist, with specific underlying gene mutations. These mutations affect the HNF1A gene, several genes leading to JAK/STAT3 pathway activation and the CTNNB1 gene. All of them are associated with more or less specific histopathological characteristics and can be recognized using immunohistochemistry either with specific antibodies or with surrogate markers. Liver pathologists and radiologists are the key actors in the identification of the different subtypes of hepatocellular adenoma by the recognition of their specific morphological features. The major impact of the classification of hepatocellular adenoma is to identify subjects who are at higher risk of malignant transformation. With the development of new molecular technologies, there is hope for a better understanding of the natural history of the different subtypes, and, particularly for their mechanisms of malignant transformation. (C) 2017 Published by Elsevier Inc.