Emura I, Ohnishi Y, Yamashita Y, Iwafuchi M
Acta Pathol Jpn. 1985 Jan;35(1):79-86. doi: 10.1111/j.1440-1827.1985.tb02207.x.
Eighteen cases of hepatocellular carcinoma in children were examined, and it was found that erythropoiesis exclusively appeared in the well differentiated type of hepatoblastoma. In such foci large immature erythroblasts were found among the tumor cells, whereas mature forms tended to gather in the subendothelial spaces or within sinusoids. Desmosome-like attachments were frequently found between immature erythroblasts and tumor cells. The tumor cells were well differentiated and had a distinct polarity. The erythropoietic foci were never found in lymph nodes, spleens and in the non-neoplastic hepatic tissues obtained by surgery or autopsy. Erythroblastic cells did not show an increase in number in the bone marrows. These findings indicate that hepatoblastoma cells in certain stages of differentiation have the capacity to induce the differentiation of pluripotent hemopoietic stem cells into the cells of erythrocytic series, or that the microenvironment composed of one or more tumor cells offer good soil for the differentiation of erythroblastic cells. There seems to be no intimate relationship between the production of alpha-fetoprotein by tumor cells and the appearance of erythropoiesis.
对18例儿童肝细胞癌进行了检查，发现红细胞生成仅出现在高分化型肝母细胞瘤中。在这些病灶中，肿瘤细胞间可见大量未成熟成红细胞，而成熟形式的红细胞倾向于聚集在内皮下间隙或肝血窦内。未成熟成红细胞与肿瘤细胞之间经常可见类似桥粒的连接。肿瘤细胞分化良好，具有明显的极性。在通过手术或尸检获得的淋巴结、脾脏及非肿瘤性肝组织中从未发现红细胞生成灶。骨髓中红细胞样细胞数量未增加。这些发现表明，处于特定分化阶段的肝母细胞瘤细胞有能力诱导多能造血干细胞分化为红细胞系细胞，或者由一个或多个肿瘤细胞组成的微环境为成红细胞的分化提供良好的土壤。肿瘤细胞产生甲胎蛋白与红细胞生成的出现之间似乎没有密切关系。
