Carcinoma : A Special Reference to Small Hepatocellular Carcinoma With Indistinct Margins
Carcinoma : A Special Reference to Small Hepatocellular Carcinoma With Indistinct Margins
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癌：特别提及边缘不明确的小肝细胞癌
DOI：
10.1002/hep.1840220116
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发表时间：
1995
期刊：
影响因子：
13.5
通讯作者：
M. Kojiro
中科院分区：
文献类型：
--
作者：
O. Nakashima;S. Sugihara;Masayoshi;Kage;M. Kojiro
一些手术切除的直径达2 cm的小肝细胞癌（HCC）边缘不清，有时难以识别切除标本中癌结节的边缘。我们将这种肿瘤归类为边缘不清的小肝癌，并进行了形态学研究，以确定其特征与边缘明显的小肝癌作为对照组。在86例直径小于2.0cm的肿瘤中，我们发现了27例。这种类型的肿瘤不清楚地保留了背景的基本结构，界限模糊。大多数肿瘤均由分化良好的癌组织组成，其特征是细胞密度增加，核/浆比增加，胞浆嗜酸性粒细胞增多，不规则的薄梁模式，偶尔有假腺模式。门脉束包括在癌组织内。在肿瘤/非肿瘤边界处存在“替代”生长模式。27个病灶中有4个呈结节中结节的外观，内部结节由中等分化的HCC组成，无汇管区。边缘不清的小肝癌均未见门静脉侵犯和肝内转移，对照组肿瘤边界清楚，53%有包膜。其中高分化9例，中分化38例，中分化12例。肿瘤侵犯门静脉16例（27.1%），肝内转移6例（10.2%）。根据上述结果，我们认为许多肝癌是一种高分化型肿瘤，含有边缘不清的小肝癌形式的汇管区。PPATOLOGY 1995; 22：101 -105.）
Some surgically resected small hepatocellular carcinoma (HCC) up to 2 cm in diameter have indistinct margins, and it is sometimes difficult to identify the margins of the cancer nodule in the resected specimen. We classified such tumors as small HCC with indistinct margins and carried out a morphological study to define their characteristics in comparison with small HCC with distinct margins as a control group. We have encountered 27 examples among 86 tumors smaller than 2.0 cm in diameter. The tumors of this type indistinctly retained the basic architecture of the background and were vaguely demarcated. Most tumors were uniformly composed of well-differentiated cancer tissue, which is characterized by increased cell density with increased nuclear/cytoplasm ratio, increased cytoplasmic eosinophilia, and irregular thin-trabecular pattern with occasional pseudoglandular pattern. Portal tracts were included within the cancerous tissue. There was a "replacing" growth pattern at the tumor/nontumor boundary. Four of the 27 lesions had a nodule-in-nodule appearance, and the inner nodules consisted of moderately differentiated HCC without portal tracts. In all of the small HCC with indistinct margins, tumor invasion into the portal vein and intrahepatic metastasis were not found. In a control group, the tumors were welldemarcated, and 53% of them were encapsulated. They were well-differentiated in 9, moderately differentiated in 38 and mixed well and moderately in 12. Tumor invasion into the portal vein and intrahepatic metastasis was found in 16 (27.1%) and 6 (10.2%), respectively. According to the above results, it is suggested that many HCCs arise as a tumor of the well-differentiated type containing portal tracts in a form of small HCC with indistinct margins. P PA TO LOGY 1995; 22:lOl-105.)