Department of Medical Biotechnology and Translational Medicine and Unit of Pathology, University of Milan and Humanitas Clinical and Research Center, Via Manzoni 56, 20089 Rozzano, Milan, Italy.
Best Pract Res Clin Gastroenterol. 2013 Apr;27(2):269-84. doi: 10.1016/j.bpg.2013.03.015.
We will focus on precursors of the most common liver cancer, i.e. hepatocellular carcinoma (HCC), which takes place in 90% of cases in a hepatitis/cirrhotic setting. High grade dysplastic nodules (HG-DN) are small sizable nodules and the most advanced precancerous lesions of the liver, with a risk of malignant transformation of about 30-40% at 24 months. We will survey the diagnostic distinction between them and early HCC from a clinical, radiological and pathological point of view. The use of a diagnostic algorithm supported by international guidelines is the best practice to manage HG-DN and early HCC. There is no typical imaging for HG-DN, needing all of them to be biopsied for characterization. The natural history of HG-DN is not predictable in individual cases and additional markers should be validated to increase the diagnostic accuracy and predict the behaviour. The treatment of HG-DN is under investigation.
我们将重点关注最常见的肝癌前体，即肝细胞癌（HCC），其在 90%的病例中发生在肝炎/肝硬化的背景下。高级别异型增生结节（HG-DN）是体积较小的结节，是肝脏最先进的癌前病变，在 24 个月时恶性转化的风险约为 30-40%。我们将从临床、影像学和病理学的角度来调查它们与早期 HCC 的诊断区别。使用国际指南支持的诊断算法是管理 HG-DN 和早期 HCC 的最佳实践。HG-DN 没有典型的影像学表现，需要对所有的结节进行活检以确定其特征。HG-DN 的自然史在个别病例中不可预测，应该验证其他标志物以提高诊断准确性并预测其行为。HG-DN 的治疗正在研究中。
