Diagnosis and treatment of multicentric occurring hepatocellular carcinoma using molecular biological technique

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<Purpose>The aim of this study was to differentiate metachronously multicentric occurring hepatocellular carcinoma (MC) from intrahepatic metastatic HCC (IM) and to clarify clinical characteristics of them.<Materials and methods>Among 110 HCC patients with solitary nodules in the diameter of less than 5 cm having no capsular invasion and portal thrombus, 45 had recurrence. Recurrent HCC of twenty-nine patients were studied. Histological criteria and molecular biological criteria using HBV-DNA integration pattern, p53 mutation pattern and nm23-H1 expression were applied to define the multicentricity.<Results>1. MC was defined in 14 patients (61 %), IM in 9 (39 %) and unclassified cases was in 6. Among 23 patients 16 was defined histologically and 7 was molecular biologically.2. Solitary recurrence were found in 1 of 9 (11 %) IM patients and 11 of 14 (80 %) MC patients, respectively (p < 0.05), well-differentiated HCC were found in 0 of 9 (0 %) and 8 of 14 (57 %), respectively (p < 0.05). Interval time between the hepatectomy and recurrence were 13.5 months in IM and 26.7 months in MC, respectively (p < 0.05).<Conclusion>1. MC was defined in 14 patients (61 %) and IM in 9 (39 %).2. From the clinical viewpoint solitary well-differentiated HCC which was detected 2 years after the hepatectomy might be MC.