Satellite lesions in patients with small hepatocellular carcinoma with reference to clinicopathologic features
Satellite lesions in patients with small hepatocellular carcinoma with reference to clinicopathologic features
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DOI：
10.1002/cncr.10892
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发表时间：
2002-11-01
期刊：
影响因子：
6.2
通讯作者：
Sakamoto, M
中科院分区：
文献类型：
--
作者：
Okusaka, T;Okada, S;Sakamoto, M
背景。在小肝细胞癌（HCC）患者中发现卫星病变并不罕见。本研究的目的是阐明与这些患者的卫星病变相关的因素。我们调查了149例患者的卫星性病变的患病率、临床病理因素与卫星性病变的关系以及主要肿瘤到卫星性病变的距离。单发HCC直径小于或等于3.0 cm但术前影像学检查无卫星病变的患者，行可能治愈的切除。主要肿瘤在宏观上分为四组：早期HCC，模糊结节型，保留了原有的肝脏结构；单结节型；单结节型伴结节外生长；合并多结节型。149例切除标本中，28例（19%）出现卫星病变。在研究的临床病理因素中，宏观类型和肿瘤分化与卫星病变的发生率有显著相关性。合并结节外生长的单结节型和合并多结节型均比早期HCC和单结节型更常出现卫星病变。低分化HCC中卫星病变的发生率明显高于分化良好和中分化HCC。8例（33%）病例的伴星病变位于距主肿瘤0.5 cm以下，12例（50%）为0.6-1.0 cm， 4例（17%）为1.1-2.0 cm。没有可识别的因素与主肿瘤到伴发病灶的距离有显著关系。而所有距主肿瘤1.0 cm以上的伴发病变均与低分化HCC共存，多为单结节型伴结节外生长或融合型多结节型。对于结节外生长的单结节型、融合多结节型和低分化型HCC，由于卫星病变的高发生率，可能需要广泛的治疗以获得较大的安全边际和/或频繁的治疗后随访检查。(C) 2002年美国癌症协会。
BACKGROUND. It is not rare to find satellite lesions in patients with small hepatocellular carcinoma (HCC). The purpose of this study was to elucidate the factors associated with satellite lesions in these patients.METHODS. We investigated the prevalence of satellite lesions, the relationship of clinicopathologic factors to satellite lesions, and the distance from the main tumor to the satellite lesion in 149 patients. Patients, who had a solitary HCC of 3.0 cm or less in diameter but no satellite lesions on preoperative imaging procedures, underwent potentially curative resection. The main tumors were macroscopically classified into four groups: early HCC, a vaguely nodular type showing preservation of the preexisting liver structure; single nodular type; single nodular type with extranodular growth; and confluent multinodular type.RESULTS. Of 149 resected specimens, 28 (19%) showed satellite lesions. Of the clinicopathologic factors investigated, the macroscopic type and tumor differentiation were significantly associated with the prevalence of satellite lesions. Both the single nodular type with extranodular growth and the confluent multinodular type showed satellite lesions more frequently than the early HCC and the single nodular type. A significantly higher prevalence of satellite lesions was observed in poorly differentiated HCC than in well and moderately differentiated HCC. The satellite lesions were located 0.5 cm or less from the main tumor in 8 (33%) specimens, 0.6-1.0 cm in 12 (50%), and 1.1-2.0 cm in 4 (17%). No identifiable factors were significantly related to the distance from the main tumor to the satellite lesion. However, all satellite lesions located more than 1.0 cm from the main tumor coexisted with poorly differentiated HCC, which were the single nodular type with extranodular growth or the confluent multinodular type.CONCLUSION. In the single nodular type with extranodular growth, confluent multinodular type, and poorly differentiated HCC, extensive treatment achieving a large safety margin and/or frequent posttreatment follow-up examinations may be needed because of the high prevalence of satellite lesions. (C) 2002 American Cancer Society.