Intrahepatic metastases in hepatocellular carcinoma: The role of the portal vein as an efferent vessel
Intrahepatic metastases in hepatocellular carcinoma: The role of the portal vein as an efferent vessel
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DOI：
10.1007/bf00115112
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发表时间：
1996-11-01
影响因子：
4
通讯作者：
Nakao, N
中科院分区：
文献类型：
--
作者：
Mitsunobu, M;Toyosaka, A;Nakao, N
肝细胞癌高频率肝内转移的机制和发病机制尚未阐明。本文对231例直径小于或等于5 cm的肝癌切除标本进行了肿瘤扩散方式与肿瘤大小关系的研究，并对其中23例随机抽取的23例切除肝标本，采用不透射线直接注入血管的方法确定了肝癌的传出血管。肝细胞癌最常见的扩散部位是包膜侵犯，其次是包膜外侵犯、血管侵犯，最后是肝内转移。肝内转移的出现与血管侵犯的频率有很强的统计学相关性(相关系数=0.998)。23个切除肿瘤直接注射不透射线物质，其中17个肿瘤仅进入门静脉，6个肿瘤同时进入门静脉和肝静脉。在所有8名不能切除病变的患者中，经皮向特纳结节内注射不透射线的介质，仅向门静脉内注射。这些发现表明，肿瘤在肝细胞癌中的扩散是从包膜侵犯进展到肝内侵犯，门静脉可能起到传出血管的作用。
The mechanism and pathogenesis of the high frequency of intrahepatic metastasis in hepatocellular carcinoma (HCC) has not yet been elucidated. Two hundred and thirty one tumors (less than or equal to 5 cm in diameter) of resected specimens of HCC were examined for the relationship between mode of tumor spread and tumor size, Efferent vessels in HCC were identified by direct injection of radiopaque material into the tamer in 23 resected liver specimens selected at random from the 231 tumors. The most frequent site For tumor spread in HCC was capsular invasion followed by extracapsular invasion, vascular invasion, and finally intrahepatic metastasis. There was a strong statistical correlation between the presence of intrahepatic metastasis and the frequency of vascular invasion (correlation coefficient=0.998). Radiopaque material injected directly into 23 resected tumors entered only the portal vein in 17 tumors and into both the portal and hepatic veins in six tumors. In all eight patients with unresectable lesions, radiopaque media injected percutaneously into turner nodules hewed only into the portal vein. These findings suggest that tumor spread in HCC progresses from capsular invasion to intrahepatic invasion and that the portal vein may act as an efferent turner vessel.