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DIAGNOSIS AND TREATMENT STRATEGY OF MULTICENTRIC HEPATOCELLULAR CARCINOMA-USING MOLECULAR BIOLOGICAL TECHNIQUE

多中心性肝细胞癌的分子生物技术诊断和治疗策略

基本信息

批准号：
08671429
负责人：
MATSUDA Masanori
金额：
$ 1.54万
依托单位：
Yamanashi Medical University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1998
项目状态：
已结题

项目摘要

In this study, we clarified the mode of development of multiple hapatocellular carcinomas (HCC) in order to make a modality of surgical treatments. We analyzed the clonalities of multiple HCC lesions taken from HCC patients with hepatitis B virus infection, who had multiple HCC nodules synchronously or metachronously, by using molecular-biological technique. For the diagnosis of the clonalities of HCCs, we used integration pattern of HBV DNA assessed by Southern blot analysis (SB). One out of 2 patients who were diagnosed as having multicentric (MC) HCCs by histological methods at operation, was confirmed as MC case by clonal analysis. But, SB was not useful for the diagnosis of the clonality of another patient. Only genetic method was useful for the diagnosis of the clonality of the MC patient who had two poorly differentiated HCCs at operation. One patient who had intrahepatic metastasis at operation also confirmed as metastatic (IM) case by SB.One patient, who had recurrent HCCs in the remnant liver 4 years after the operation, was clinically diagnosed as metachronous MC case, but SB revealed that the recurrent HCCs had the same origin as primary 11CC.From these results, we can conclude that the genetic methods are indispensable for the diagnosis of clonalities of HCCs. Our clinical observations also indicated that for longer survival after hepatectomy of 11CC patients, we should choose appropriate treatments based on the mode of development of recurrent HCC.

在这项研究中，我们阐明了多发性肝细胞癌（HCC）的发展模式，以便制定手术治疗方式。我们采用分子生物学技术，分析了乙型肝炎病毒感染的 HCC 患者同时或异时具有多个 HCC 结节的多个 HCC 病灶的克隆性。为了诊断 HCC 克隆，我们使用了通过 Southern blot 分析 (SB) 评估的 HBV DNA 整合模式。术中通过组织学方法诊断为多中心（MC）HCC 的患者中，每 2 名患者中就有 1 名通过克隆分析确诊为 MC 病例。但是，SB 对于诊断另一名患者的克隆性没有用。对于术中患有两处低分化 HCC 的 MC 患者，只有遗传学方法才能诊断其克隆性。 1例手术时出现肝内转移的患者也被SB证实为转移（IM）病例。1例患者术后4年残肝复发HCC，临床诊断为异时性MC病例，但SB发现复发HCC与原发11CC同源。从这些结果我们可以得出结论，遗传学方法对于克隆性的诊断是不可或缺的。的 HCC。我们的临床观察也表明，为了使11CC患者肝切除后获得更长的生存期，我们应该根据复发性HCC的发展模式选择合适的治疗方法。