Terada T, Nakanuma Y
Second Department of Pathology, Kanazawa University School of Medicine, Japan.
Hepatology. 1989 Nov;10(5):851-4. doi: 10.1002/hep.1840100517.
Recently, macroregenerative nodules in cirrhotic livers have been suspected to be among the putative precancerous lesions in human hepatocarcinogenesis. We examined the morphologies of 99 macroregenerative nodules in 44 cirrhotic livers with special emphasis on stainable iron. In 26 macroregenerative nodules (26%), stainable iron selectively accumulated within the macroregenerative nodules themselves, and little or no iron was found in the surrounding regenerative nodules. In nine macroregenerative nodules (9%), an appreciable amount of stainable iron was present in both the macroregenerative nodules and the surrounding regenerative nodules. In the remaining 64 macroregenerative nodules (65%), stainable iron was absent in both the macroregenerative nodules and the surrounding regenerative nodules. Hyperplastic hepatocellular foci were present within 19 (73%) of the 26 iron-accumulative macroregenerative nodules, one (11%) of the nine iron-positive macroregenerative nodules and 20 (31%) of the 64 iron-negative macroregenerative nodules. These findings suggest that iron-accumulative macroregenerative nodules are frequently associated with hyperplastic hepatocellular foci and should be included among the precancerous lesions in human hepatocellular carcinoma.
最近，肝硬化肝脏中的大再生结节被怀疑是人类肝癌发生过程中假定的癌前病变之一。我们检查了44例肝硬化肝脏中99个大再生结节的形态，特别关注可染色铁。在26个大再生结节（26%）中，可染色铁选择性地在大再生结节内积聚，而在周围的再生结节中很少或没有发现铁。在9个大再生结节（9%）中，大再生结节和周围的再生结节中都存在相当数量的可染色铁。在其余64个大再生结节（65%）中，大再生结节和周围的再生结节中均无可染色铁。在26个铁积聚性大再生结节中的19个（73%）、9个铁阳性大再生结节中的1个（11%）以及64个铁阴性大再生结节中的20个（31%）中存在肝细胞增生灶。这些发现表明，铁积聚性大再生结节常与肝细胞增生灶相关，应被纳入人类肝细胞癌的癌前病变之中。
