Sugiki Takaaki, Yamamoto Masakazu, Taka Ken, Nakano Masayuki
Department of Gastroenterological Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho Shinjuku-ku, 162-8666 Tokyo, Japan.
Hepatogastroenterology. 2009 Jul-Aug;56(93):1086-9.
BACKGROUND/AIMS: Scirrhous hepatocellular carcinoma has been defined within general hepatocellular carcinoma. To define scirrhous hepatocellular carcinoma, the present study identified the specific characteristics as compared with general hepatocellular carcinoma.
The scirrhous hepatocellular carcinoma was defined when almost all areas of the tumor were occupied with scirrhous structures. It was identified 14 patients with scirrhous hepatocellular carcinoma and 300 patients with general hepatocellular carcinoma (control), all underwent hepatectomy from 1988 to 1994. It was compared the clinical background of the patients, prognosis, and pathological features, which included immunohistological staining using Hepatocyte Paraffin 1.
All scirrhous hepatocellular carcinoma showed whitish, hard forms resembling intrahepatic cholangiocarcinoma. The rates of average ICGR15, positive hepatitis C virus antibody, and microscopic invasion to the bile duct were 12%, 33%, and 20%, respectively, each significantly different than general hepatocellular carcinoma. The cumulative 10-year survival rate of scirrhous hepatocellular carcinoma and general hepatocellular carcinoma were 70% and 31%, respectively. With immunohistological staining, 43% of scirrhous hepatocellular carcinoma showed negative staining for Hepatocyte Paraffin 1.
The scirrhous hepatocellular carcinoma has specific characteristics such as lower rates of hepatitis C virus infection, better prognosis, and different histological findings; therefore, scirrhous hepatocellular carcinoma should be strictly classified under a new category.
背景/目的：在一般肝细胞癌中已定义了硬化型肝细胞癌。为明确硬化型肝细胞癌，本研究确定了其与一般肝细胞癌相比的具体特征。
当肿瘤几乎所有区域都被硬化结构占据时定义为硬化型肝细胞癌。确定了14例硬化型肝细胞癌患者和300例一般肝细胞癌患者（对照组），所有患者均在1988年至1994年期间接受了肝切除术。比较了患者的临床背景、预后和病理特征，其中包括使用肝细胞石蜡1进行免疫组织化学染色。
所有硬化型肝细胞癌均表现为类似肝内胆管癌的白色、坚硬形态。平均ICGR15、丙型肝炎病毒抗体阳性率和胆管微浸润率分别为12%、33%和20%，均显著不同于一般肝细胞癌。硬化型肝细胞癌和一般肝细胞癌的10年累积生存率分别为70%和31%。免疫组织化学染色显示，43%的硬化型肝细胞癌对肝细胞石蜡1呈阴性染色。
硬化型肝细胞癌具有丙型肝炎病毒感染率较低、预后较好以及不同组织学表现等特定特征；因此，硬化型肝细胞癌应严格归类为一个新的类别。
