Multistep human hepatocarcinogenesis: correlation of imaging with pathology
Multistep human hepatocarcinogenesis: correlation of imaging with pathology
复制标题
DOI：
10.1007/s00535-008-2274-6
复制
发表时间：
2009-01-01
影响因子：
6.3
通讯作者：
Kudo, Masatoshi
中科院分区：
文献类型：
--
作者：
Kudo, Masatoshi
肝细胞癌是世界范围内最常见的恶性肿瘤之一。大多数肝细胞癌发生在肝硬变中，早期发现和定性这种实体是非常重要的。在病理学上，人类肝细胞癌的发展是一个多步骤的过程，其发展顺序如下：从低度发育不良结节(LGDN)，到高度发育不良结节(HGDN)，早期肝癌，高分化肝癌，结节内肝癌，最后到中分化肝癌。鉴别早期肝细胞癌和糖尿病肾病是临床上最重要的问题。肝血管造影CT(CTHA)和肝动脉门脉造影CT(CTAP)是鉴别癌前病变/交界性病变(LGDN和HGDN)和早期肝细胞癌最敏感的工具。近年来，随着影像技术的进步，特别是Sonazid增强超声和Gd-EOB-DTPA MRI在多步骤肝癌的影像诊断中发挥了重要作用，从而改变了这些与肝硬变相关的结节病变的治疗策略。
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. The majority of HCCs develop in cirrhotic livers, and the early detection and characterization of this entity is very important. Pathologically, human HCC develops in a multistep fashion in the following sequence: from low-grade dysplastic nodule (LGDN), to high-grade dysplastic nodule (HGDN), early HCC, well-differentiated HCC, nodule-in-nodule HCC, and, finally, to moderately differentiated HCC. Differentiation between early HCC and DN is the most important issue in the clinical setting. CT during hepatic angiography (CTHA) and CT during arterial portography (CTAP) are the most sensitive tools in the differentiation of premalignant/borderline lesions (LGDN and HGDN) and early HCC. Recent progress in imaging modality, especially Sonazoid-enhanced US and Gd-EOB-DTPA MRI, is starting to play a very important role in the imaging of multistep hepatocarcinogenesis, resulting in changing the therapeutic strategy of these nodular lesions associated with liver cirrhosis.