GREF Inserm U1053, service d'anatomie pathologique, hôpital Pellegrin, CHU de Bordeaux, université Bordeaux-Segalen, 33076 Bordeaux cedex, France.
Clin Res Hepatol Gastroenterol. 2011 Dec;35(12):783-5. doi: 10.1016/j.clinre.2011.08.006. Epub 2011 Oct 1.
Cirrhotic nodules containing hepatocytes are surrounded by perinodular stroma, that consists of an expanded fibrous matrix and epithelial cells with ductular phenotype, the "ductular-reaction". Stromal invasion is a key histopathologic feature used to differentiate premalignant dysplastic nodules from malignant hepatocellular carcinoma (HCC). K19 immunoreactivity in the stromal compartment in cirrhotic explants was examined. Quantitative differences were manifested in three distinct histologically identifiable patterns: "complex" around cirrhotic nodules, "attenuated" around dysplastic nodules, and "absent" around HCC. These findings suggest marked alterations in cellular identity as an underlying mechanism for the reproducible extralesional K19 pattern that parallels progressive stages of intranodular hepatocarcinogenesis. Paracrine signalling is proposed as a link that emphasizes the importance of the epithelial-stromal compartment in malignant progression of HCC in cirrhosis.
肝硬化结节中的肝细胞被周围的结节间基质所包围，该基质由扩展的纤维基质和具有胆管表型的上皮细胞组成，即“胆管反应”。基质浸润是用于区分癌前异型增生结节和恶性肝细胞癌（HCC）的关键组织病理学特征。研究了肝硬化标本中基质区的 K19 免疫反应。在三种不同的组织学可识别的模式中表现出定量差异：肝硬化结节周围的“复杂”模式、异型增生结节周围的“减弱”模式和 HCC 周围的“缺失”模式。这些发现表明，细胞身份的明显改变是可重复的病灶外 K19 模式的潜在机制，该模式与结节内肝细胞癌发生的渐进阶段相平行。旁分泌信号被认为是一种联系，强调了上皮-间质区在肝硬化中 HCC 恶性进展中的重要性。
