The cytological characteristics of small cell change of dysplasia in small hepatic nodules
The cytological characteristics of small cell change of dysplasia in small hepatic nodules
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DOI：
10.3892/or_00000754
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发表时间：
2010-05-01
期刊：
影响因子：
4.2
通讯作者：
Hayashi, Yoshitake
中科院分区：
文献类型：
--
作者：
Chang, Okki;Yano, Yoshihiko;Hayashi, Yoshitake
小细胞异型增生（SCD）是肝癌发生的起始阶段。组织学诊断是肝脏结节性病变的重要诊断步骤。然而，活检标本太小，有时甚至在组织学上也很难区分再生结节、异型增生结节和肝细胞癌。为了研究细胞学在肝结节性病变鉴别诊断中的作用，使用巴氏染色和千分尺评估SCD的细胞特征。回顾性分析了64例经组织学诊断的肝脏小结节性病变。所有病例均根据国际工作组的结节性肝细胞病变术语进行组织学分类：肝细胞癌（HCC）17例;低度异型增生结节（LGDN）26例;高度异型增生结节（HGDN）6例;大再生结节15例。SCD在所有的组织学分类中均被发现，并且SCD在W-HCC中的比例往往高于异型增生结节。虽然HGDN的细胞尺寸最小，但高分化HCC（W-HCC）的细胞核尺寸最大。HGDN和W-HCC的核质比高于其他结节性病变。W-HCC的染色质明显强于其他结节。SCD多见于HGDN和W-HCC。本研究表明，SCD的详细细胞学检查有助于HGDN与LGDN以及HGDN与W-HCC的鉴别。
Small cell change of dysplasia (SCD) is characterized as an initial step in hepatocarcinogenesis. Histopathological diagnosis is an important diagnostic procedure for nodular lesions in the liver. However, the biopsied specimen is so small that it is sometimes difficult to differentiate between regenerative nodules, dysplastic nodules, and hepatocellular carcinoma even histologically. To examine the usefulness of cytology in the differential diagnosis of hepatic nodular lesions, the cellular characteristics of SCD were evaluated using Papanicolaou staining and a micrometer. Sixty-four histologically diagnosed small nodular lesions in the liver were analyzed retrospectively. All cases were histologically classified according to the Terminology of Nodular Hepatocellular Lesions by the International Working party: hepatocellular carcinoma (HCC) (n=17); low-grade dysplastic nodule (LGDN) (n=26); high-grade dysplastic nodule (HGDN) (n=6); large regenerative nodule: (n=15). SCD was noted in all of the histological categories, and the proportion of SCD tended to be higher in W-HCC than in dysplastic nodules. Although the cellular size was the smallest in HGDN, the nuclear size was the largest in well-differentiated HCC (W-HCC). The nuclear/cytoplasmic ratio was higher in HGDN and W-HCC than in other nodular lesions. Hyperchromasia in W-HCC was obviously stronger than that in other nodules. SCD was frequently found in HGDN and W-HCC. The present study showed that detailed cytological findings of SCD are useful for differentiating HGDN from LGDN, and HGDN from W-HCC.