Sawabe M, Nakamura T, Kanno J, Kasuga T
2nd Department of Pathology, Faculty of Medicine, Tokyo Medical and Dental University, Japan.
Acta Pathol Jpn. 1987 Sep;37(9):1389-404. doi: 10.1111/j.1440-1827.1987.tb02261.x.
The morphological features of ninety-eight autopsy cases of hepatocellular carcinoma (HCC) were analyzed in relation to pulmonary metastasis. Extrahepatic hematogenous metastasis was observed in 64% and lung was most frequently involved (62%). A close relationship was observed between intrahepatic vascular invasion and extrahepatic hematogenous metastasis to lungs. Portal vein-invasion was found in 80% of cases and significant correlations were recognized between the rates of portal vein-invasion and hepatic vein-invasion, and between the rates of portal vein-invasion and pulmonary metastasis. There was a close correlation among the macroscopic growth-pattern, incidence of vascular invasion, and pulmonary metastasis, and their degrees. Namely, the expansive type HCC showed significantly lower rates of vascular invasion and pulmonary metastasis than the infiltrative or mixed type HCC. These rates were particularly low in the expansive type, single nodular subtype HCC with size of a primary tumor less than 10 cm. Significantly low rates of pulmonary metastasis and portal vein-invasion were also noted in well-differentiated carcinoma (Grade I or II). The existence of cirrhosis or fibrosis of liver in cases with HCC was not definitely related to the occurrence of pulmonary metastasis. It was originally clarified that invasion to the portal vein and the size of HCC played a main role in pulmonary metastasis.
对98例肝细胞癌（HCC）尸检病例的形态学特征与肺转移的关系进行了分析。64%的病例观察到肝外血行转移，其中肺是最常受累的器官（62%）。肝内血管侵犯与肝外血行转移至肺之间存在密切关系。80%的病例发现有门静脉侵犯，门静脉侵犯率与肝静脉侵犯率之间以及门静脉侵犯率与肺转移率之间存在显著相关性。宏观生长模式、血管侵犯发生率和肺转移及其程度之间存在密切相关性。即，膨胀型HCC的血管侵犯率和肺转移率明显低于浸润型或混合型HCC。在膨胀型、单个结节亚型且原发肿瘤大小小于10 cm的HCC中，这些比率尤其低。高分化癌（I级或II级）的肺转移率和门静脉侵犯率也明显较低。HCC病例中肝脏肝硬化或纤维化的存在与肺转移的发生没有明确关系。最初明确门静脉侵犯和HCC大小在肺转移中起主要作用。
