Oikawa Takuichi, Ojima Hidenori, Yamasaki Susumu, Takayama Tadatoshi, Hirohashi Setsuo, Sakamoto Michiie
Pathology Division, National Cancer Center Research Institute, Tokyo, Japan.
J Hepatol. 2005 Feb;42(2):225-9. doi: 10.1016/j.jhep.2004.10.024.
BACKGROUND/AIMS: Histological observations support the concept of multistep and multicentric development of hepatocellular carcinoma (HCC) in cases of chronic liver disease. However, the relationship between the incidence of such a modality of development of HCC and the type of background liver disease has not been fully investigated.
A total of 980 HCC nodules resected from 664 patients were analyzed. Multistep HCC was defined as well differentiated HCC containing the portal tracts (early HCC), or the presence of early HCC-like areas in the periphery of the nodule. In cases with multiple nodules, if the smaller nodule showed the features of multistep HCC, or if each nodule showed a distinct histology, the case was defined to have multicentric HCC.
Of the 980 nodules, 369 (37.7%) met the criteria of multistep HCC. Of the 664 patients, 177 (26.7%) had multiple nodules that met the criteria of multicentric HCC. Both the incidences of multistep and multicentric HCC were significantly higher in HCV-Ab-positive cases than in HBs-Ag-positive cases (46.0 vs. 19.1%, P<0.001 and 34.1 vs. 16.5%, P=0.005, respectively).
Multistep and multicentric HCC develops most frequently in patients with HCV infection.
背景/目的：组织学观察支持慢性肝病病例中肝细胞癌（HCC）多步骤和多中心发展的概念。然而，HCC这种发展模式的发生率与背景肝病类型之间的关系尚未得到充分研究。
对664例患者切除的980个HCC结节进行分析。多步骤HCC定义为包含门静脉分支的高分化HCC（早期HCC），或结节周边存在早期HCC样区域。在多结节病例中，如果较小的结节具有多步骤HCC的特征，或每个结节具有不同的组织学表现，则该病例定义为多中心HCC。
980个结节中，369个（37.7%）符合多步骤HCC标准。664例患者中，177例（26.7%）有多结节符合多中心HCC标准。HCV-Ab阳性病例中多步骤和多中心HCC的发生率均显著高于HBs-Ag阳性病例（分别为46.0%对19.1%，P<0.001；34.1%对16.5%，P=0.005）。
多步骤和多中心HCC最常发生于HCV感染患者。
