Inayoshi Jun, Ichida Takafumi, Sugitani Soichi, Tsuboi Yasunori, Genda Takuya, Honma Nobuyuki, Asakura Hitoshi
Department of Internal Medicine III, Niigata University School of Medicine, Niigata, Japan.
J Gastroenterol Hepatol. 2003 Jun;18(6):673-7. doi: 10.1046/j.1440-1746.2003.03021.x.
Correlation between the gross classification of hepatocellular carcinoma (HCC) and its vascular invasion or intrahepatic metastasis has been reported previously. Because E-cadherin-mediated epithelial cell-to-cell adhesion is thought to suppress cancer cell invasion, the present study was performed to analyze the correlation between E-cadherin expression and the gross classification of HCC.
Thirty-six resected solitary HCC <6 cm in diameter were each classified as single nodular type (type 1), single nodular with extranodular growth type (type 2) or contiguous multinodular type (type 3), and the clinicopathological and prognostic differences between type 1 HCC and the other types were analyzed. The expression of E-cadherin in each tumor was examined by immunoblotting and immunohistochemical analysis.
Vascular invasion and microscopic intrahepatic metastasis were observed more frequently in types 2 and 3 (61%) than in type 1 (13%) HCC. Immunoblot analysis indicated that the relative level of E-cadherin expression in cancerous tissue was significantly lower in type 2 and 3 (0.75 +/- 0.49) than in type 1 (1.46 +/- 0.79) HCC. Immunohistochemical examination revealed decreased and partially absent E-cadherin expression in the tumorous area of type 2 and 3 HCC. The recurrence-free survival rate was higher for patients with type 1 HCC than for those with the other types.
Types 2 and 3 HCC have marked metastatic and invasive potential and reduced expression of E-cadherin, predicting a high risk of recurrence after surgical treatment.
先前已有报道肝细胞癌（HCC）的大体分类与其血管侵犯或肝内转移之间的相关性。由于E-钙黏蛋白介导的上皮细胞间黏附被认为可抑制癌细胞侵袭，因此本研究旨在分析E-钙黏蛋白表达与HCC大体分类之间的相关性。
将36例直径<6 cm的手术切除的孤立性HCC分别分为单结节型（1型）、单结节伴结节外生长型（2型）或连续多结节型（3型），分析1型HCC与其他类型之间的临床病理及预后差异。通过免疫印迹和免疫组织化学分析检测各肿瘤中E-钙黏蛋白的表达。
2型和3型HCC（61%）比1型HCC（13%）更频繁地观察到血管侵犯和微小肝内转移。免疫印迹分析表明，2型和3型HCC癌组织中E-钙黏蛋白表达的相对水平（0.75±0.49）显著低于1型HCC（1.46±0.79）。免疫组织化学检查显示，2型和3型HCC肿瘤区域的E-钙黏蛋白表达降低且部分缺失。1型HCC患者的无复发生存率高于其他类型患者。
2型和3型HCC具有显著的转移和侵袭潜能，且E-钙黏蛋白表达降低，提示手术治疗后复发风险高。
