HISTOPATHOLOGICAL CHARACTERISTICS OF THE EARLY STAGE AND ONCOGENOUS EXPRESSION IN PRIMARY HEPATOCELLULAR CARTINOMA

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Early diagnosis - treatment is essential for improving the prognosis of hepatocellular carcinoma (HCC) However, the Pathomorphology of this disease in the early stage has hardly be elucidated.In the totally 472 resected cases of HCC, 111 cases of small liver cancer(less than 3cm in diameter) containing of 23 cases of minute liver cancer(less than 2 cm in diameter) were investigated by cytomorphological analysis, immunohistochemical study, flow cytometric study on nuclear DNA analysis and expression of cellular oncogenes.1)In the histology of non-cancerous region not only completed cirrhosis of type B but also a precirrhotic lesion from chronic hepatitis to type B'cirrhosis were observed in a considerable number, especially in large liver cancers.2)Minute liver cancers showed extracapsular invasion in 60%, intrahepatic metasis in 25%. Considerable advance was observed even when the tumor was less than 2cm in diameter. The HCC with slight or mild cirrhosis revealed the low rates of invas … More ion and metastasis.3)Small liver cancer consisted primarily of differentiated cells of Ed I and II types.4)In the distant areas from main tumors, minute daughter masses with no capsule and poorly defined border, consisting smaller, proliferative hepatocellular-cells were observed, and this lesions have been frequently called adenomatous hyperplasia. However, this minute mass showed high N/C ratio in the cytometry, and often had small foci of HCC, though showing negative tumor makers in the immunohistochemistry. Therefore we consider this minute focus to be, indeed, the early lesion of UCC.5)In the DNA ploidy, small liver cancers showed a significantly higher rate of diploid pattern compared with large tumors.6)In the oncogenous expression, 5 oncogenes of C-myc, C-Ha-ras, N-ras. lca and C- fos were examined in 17 HCC, and N-ras and C-myc were elevated in nearly all cases. However no oncogenous expression were detected in the minute cancers.7)The morphology of a early stage of HCC was suggested to be highly well-differentiated cytomorphologic features that show few deviations from normal liver cells. Less