MALIGNANT TRANSFORMATION OF ADENOMATOUS HYPERPLASIA TO HEPATOCELLULAR-CARCINOMA
MALIGNANT TRANSFORMATION OF ADENOMATOUS HYPERPLASIA TO HEPATOCELLULAR-CARCINOMA
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DOI：
10.1016/0140-6736(90)92768-d
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发表时间：
1990-11-10
期刊：
影响因子：
168.9
通讯作者：
HASEGAWA, H
中科院分区：
文献类型：
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作者：
TAKAYAMA, T;MAKUUCHI, M;HASEGAWA, H
为了明确肝脏腺瘤性增生 (AH) 的病程，我们对 17 名患有 20 个活检证实的 AH 结节的患者进行了 1-5 年的临床随访。在初始活检时，平均结节直径为10(SD 4)mm，相对细胞构成[(AH的平均细胞构成除以平均实质细胞构成]×100)141(27)。 AH恶变的诊断标准是结节体积倍增和影像学改变。活检后6至50个月，仍能准确识别的18个结节中有9个符合转化标准；随后获得了这 9 个结节中 7 个的肝细胞癌 (HCC) 组织学证据。直径和细胞结构的乘积（转化指数）是转化时间的最强预测因子。 9 个 AH 结节未发生转化。sbd.7 不符合一项或两项标准，2 项变得无法通过成像检测到。由于恶变风险较高，因此可以断定AH是HCC的绝对前兆。因此，应将其视为潜在的恶性疾病。
To clarify the course of adenomatous hyperplasia (AH) of the liver, 17 patients with 20 biopsy-proven AH nodules were followed clinically for 1-5 years. At the initial biopsy the mean nodular diameter was 10 (SD 4) mm and the relative cellularity [(mean cellularity of AH divided by mean parenchymal cellularity] .times. 100) 141 (27). The criteria for diagnosis of malignant transformation of AH were both a doubling of nodular volume and changes on imaging. Between 6 and 50 months after biopsy, 9 of the 18 nodules which could still be accurately identified met the criteria for transformation; histological proof of hepatocellular carcinoma (HCC) was obtained later for 7 of these 9 nodules. The product of diameter and cellularity (transformation index) was the strongest predictor of the time to transformation. 9 AH nodules did not undergo transformation.sbd.7 did not meet one or both criteria and 2 became undetectable by imaging. Because of the high risk of malignant transformation, it can be concluded that AH is an absolute precursor of HCC. It should therefore be treated as a potential malignant disorder.