Clinicopathological study of scirrhous hepatocellular carcinoma
Clinicopathological study of scirrhous hepatocellular carcinoma
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DOI：
10.1111/j.1440-1746.2006.04372.x
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发表时间：
2006-09-01
影响因子：
4.1
通讯作者：
Kojiro, Masamichi
中科院分区：
文献类型：
--
作者：
Kurogi, Mina;Nakashima, Osamu;Kojiro, Masamichi
背景与目的：硬化性肝细胞癌以肿瘤弥漫性纤维化为特征，其临床病理特征尚不完全清楚。本研究旨在阐明小肝癌的临床病理特征。方法：在546例连续切除的未经抗癌治疗的肝癌中，选择25例小肝癌作为研究对象，并与521例未经抗癌治疗的小肝癌进行对照。在影像诊断上，小肝癌常被误诊为胆管细胞癌、肝细胞癌合并胆管细胞癌或转移癌。总存活率明显高于对照组。小肝癌的平均(+/-SD)肿瘤大小为3.4+/-1.8 cm，与对照组无显著差异。大多数小肝癌(88%)位于靠近肝包膜的地方。小肝癌以星状纤维化(84%)、无包膜(100%)、无坏死和出血(100%)、瘤内汇管样改变(80%)、显著淋巴细胞浸润(84%)、透明细胞改变(84%)和透明小体(52%)为特征。肿瘤中α-平滑肌肌动蛋白阳性的肌成纤维细胞样细胞(活化的星状细胞)的数量约为对照组的3倍。结论：小肝癌具有特征性的临床病理特征，临床和病理工作者对小肝癌的认识具有重要意义。
Background and Aims: Scirrhous hepatocellular carcinoma (SHCC) is characterized by diffuse fibrosis of the tumor, however, its clinicopathological features are not fully clarified. This study aimed to clarify the clinicopathological features of SHCC.Methods: Among 546 consecutively resected HCC without preoperative anticancer therapies, 25 SHCC were selected for the study and compared with 521 cases without scirrhous as the control.Results: SHCC accounted for 4.6% of cases. On diagnostic imagings, SHCC was frequently misdiagnosed as cholangiocarcinoma (CC), combined HCC-CC or metastatic carcinoma. Overall survival rate was significantly higher than the control. The average (+/- SD) tumor size of SHCC was 3.4 +/- 1.8 cm without significant difference to the control. The majority of SHCC (88%) were located close to the liver capsule. SHCC was characterized by stellate fibrosis (84%), no encapsulation (100%), no necrosis and hemorrhage (100%), intratumoral portal tracts (80%), remarkable lymphocyte infiltration (84%), clear cell change (84%), and hyaline bodies (52%). The number of alpha-smooth muscle actin-positive myofibroblast-like cells (activated stellate cells) in the tumor was about three times more than that in the control. Regarding the developmental mechanism of scirrhous change, a close correlation with unique tumor location and activation of stellate cells was suggested.Conclusion: SHCC presents with characteristic clinicopathological features and the recognition of SHCC is important for both clinicians and pathologists.