Morphologic approach to hepatocellular carcinoma development in man: de novo or the so-called 'dysplastic nodule-carcinoma' sequence?
Morphologic approach to hepatocellular carcinoma development in man: de novo or the so-called 'dysplastic nodule-carcinoma' sequence?
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人类肝细胞癌发展的形态学方法：从头还是所谓的“发育不良结节癌”序列？
DOI：
10.3892/or.9.4.737
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发表时间：
2002
期刊：
影响因子：
4.2
通讯作者：
M. Tsuneyoshi
中科院分区：
文献类型：
--
作者：
K. Taguchi;Y. Asayama;S. Aishima;H. Nishi;K. Sugimachi;S. Matsuura;T. Terashi;T. Yamanaka;M. Shimada;K. Sugimachi;M. Tsuneyoshi
肝细胞癌是一种常见的癌前病变，因此肝细胞癌的发生顺序被称为发育不良结节-癌。为了评估原发性肝癌的存在和频率，我们研究了112例手术切除的早期高分化肝细胞癌，这些癌本身没有低分化成分，显示出替代性生长。将其分为异型增生区癌（A型）和无异型增生区癌（B型）两组进行临床病理分析。A型77例（68.8%），B型35例（31.2%）。A型糖尿病组（74.7%）明显高于非糖尿病组（54.5%）（P=0.0453）。多因素分析显示，A型肝炎的发生与年龄、肝硬化和B型肝炎表面抗原阳性有关。肿瘤大小及脂肪样变与A型有关。我们从形态学上提出早期肝癌发生的两条途径，其中一条与B型肝炎病毒和/或肝硬化密切相关。
The so-called dysplastic nodule-carcinoma sequence in the liver is generally accepted because hepatocellular carcinoma is not an uncommon finding in precancerous lesions. In order to evaluate the existence and frequency of de novo hepatocarcinogenesis we studied 112 surgically resected early well-differentiated hepatocellular carcinomas showing replacing growth without less differentiated component in themselves. They were divided into two groups: carcinoma in dysplastic area (type A) and carcinoma without dysplastic area (type B) and were analyzed clinicopathologically. We encountered 77 cases of type A (68.8%) and 35 of type B (31.2%). The frequency of type A in cirrhotic group (74.7%) is statistically higher than that of non-cirrhotic group (54.5%) (p=0.0453). Using multivariate analysis, the occurrence of type A was related with higher age, the presence of cirrhosis and hepatitis B surface antigen positive. The tumor size and the presence of fatty change in the tumor tended to relate with type A. We propose two pathways morphologically in early hepatocarcinogenesis, one of which has a close relation to hepatitis B virus and/or cirrhosis.