Hytiroglou Prodromos, Park Young Nyun, Krinsky Glenn, Theise Neil D
Department of Pathology, Aristotle University Medical School, 54006 Thessaloniki, Greece.
Gastroenterol Clin North Am. 2007 Dec;36(4):867-87, vii. doi: 10.1016/j.gtc.2007.08.010.
Precancerous lesions that may be detected in chronically diseased, usually cirrhotic livers, include: clusters of hepatocytes with atypia and increased proliferative rate (dysplastic foci) that usually represent an incidental finding in biopsy or resection specimens; and grossly evident lesions (dysplastic nodules) that may be detected on radiologic examination. There are two types of small hepatocellular carcinoma (HCC) (defined as HCC that measures less than 2 cm): early HCC, which is well-differentiated and has indistinct margins; and distinctly nodular small HCC, which is well- or moderately differentiated, and is usually surrounded by a fibrous capsule. Precise diagnosis of precancerous and early cancerous lesions by imaging methods is often difficult or impossible. Detection of a dysplastic lesion in a biopsy specimen is a marker of increased risk for HCC development, and warrants increased surveillance. High-grade dysplastic nodules and small HCCs should be treated by local ablation, surgical resection, or liver transplantation.
在慢性疾病（通常为肝硬化）肝脏中可能检测到的癌前病变包括：具有异型性和增殖率增加的肝细胞簇（发育异常灶），这通常是活检或切除标本中的偶然发现；以及在放射学检查中可能检测到的肉眼可见病变（发育异常结节）。有两种类型的小肝细胞癌（HCC）（定义为直径小于2 cm的HCC）：早期HCC，分化良好且边界不清；以及明显结节状小HCC，分化良好或中等分化，通常被纤维包膜包围。通过成像方法对癌前和早期癌性病变进行精确诊断通常很困难或不可能。在活检标本中检测到发育异常病变是HCC发生风险增加的标志，需要加强监测。高级别发育异常结节和小HCC应采用局部消融、手术切除或肝移植治疗。
