Schirmacher P, Longerich T
Pathologisches Institut, Universitätsklinik Heidelberg, Im Neuenheimer Feld 220, 69120 Heidelberg.
Pathologe. 2009 Dec;30 Suppl 2:200-6. doi: 10.1007/s00292-009-1214-4.
Biopsy diagnosis of early and highly differentiated liver tumors is one of the most challenging tasks in histopathology. During recent years its parameters have changed fundamentally due to shifting clinical algorithms. Modern histopathology has met this challenge by defining new, prognostically relevant subtypes of early hepatocellular carcinoma and by elaborating morphological algorithms and novel immunohistological markers for the differential diagnosis of highly differentiated hepatocellular tumors. In addition, a new, predictive molecular pathological and histological classification of liver cell adenoma has been developed. By means of the consequent application of these new diagnostic tools, together with the so-called 'matrix diagnosis', a reliable diagnosis is achieved in the vast majority of these difficult cases.
早期高分化肝肿瘤的活检诊断是组织病理学中最具挑战性的任务之一。近年来，由于临床算法的转变，其参数已发生了根本性变化。现代组织病理学通过定义早期肝细胞癌新的、与预后相关的亚型，以及阐述高分化肝细胞肿瘤鉴别诊断的形态学算法和新型免疫组织学标志物，应对了这一挑战。此外，还开发了一种新的、具有预测性的肝细胞腺瘤分子病理和组织学分类。通过这些新诊断工具的持续应用，以及所谓的“基质诊断”，在绝大多数这类疑难病例中都能实现可靠诊断。
