Hao Yoshiteru, Numata Kazushi, Ishii Tomohiro, Fukuda Hiroyuki, Maeda Shin, Nakano Masayuki, Tanaka Katsuaki
Yoshiteru Hao, Kazushi Numata, Tomohiro Ishii, Hiroyuki Fukuda, Katsuaki Tanaka, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Kanagawa 232-0024, Japan.
World J Gastroenterol. 2017 May 7;23(17):3111-3121. doi: 10.3748/wjg.v23.i17.3111.
To evaluate whether pathologically early hepatocellular carcinoma (HCC) exhibited local tumor progression after radiofrequency ablation (RFA) less often than typical HCC.
Fifty pathologically early HCCs [tumor diameter (mm): mean, 15.8; range, 10-23; follow-up days after RFA: median, 1213; range, 216-2137] and 187 typical HCCs [tumor diameter (mm): mean, 15.6; range, 6-30; follow-up days after RFA: median, 1116; range, 190-2328] were enrolled in this retrospective study. The presence of stromal invasion (namely, tumor cell invasion into the intratumoral portal tracts) was considered to be the most important pathologic finding for the diagnosis of early HCCs. Typical HCC was defined as the presence of a hyper-vascular lesion accompanied by delayed washout using contrast-enhanced computed tomography or contrast-enhanced magnetic resonance imaging. Follow-up examinations were performed at 3-mo intervals to monitor for signs of local tumor progression. The local tumor progression rates of pathologically early HCCs and typical HCCs were then determined using the Kaplan-Meier method.
During the follow-up period for the 50 pathologically early HCCs, 49 (98%) of the nodules did not exhibit local tumor progression. However, 1 nodule (2%) was associated with a local tumor progression found 636 d after RFA. For the 187 typical HCCs, 46 (24.6%) of the nodules exhibited local recurrence after RFA. The follow-up period until the local tumor progression of typical HCC was a median of 605 d, ranging from 181 to 1741 d. Among the cases with typical HCCs, local tumor progression had occurred in 7.0% (7/187), 16.0% (30/187), 21.9% (41/187) and 24.6% (46/187) of the cases at 1, 2, 3 and 4 years, respectively. Pathologically early HCC was statistically associated with a lower rate of local tumor progression, compared with typical HCC, when evaluated using a log-rank test ( = 0.002).
The rate of local tumor progression for pathologically early HCCs after RFA was significantly lower than that for typical HCCs.
评估病理早期肝细胞癌（HCC）经射频消融（RFA）后局部肿瘤进展的发生率是否低于典型HCC。
本回顾性研究纳入了50例病理早期HCC[肿瘤直径（mm）：平均15.8；范围10 - 23；RFA后随访天数：中位数1213；范围216 - 2137]和187例典型HCC[肿瘤直径（mm）：平均15.6；范围6 - 30；RFA后随访天数：中位数1116；范围190 - 2328]。间质浸润（即肿瘤细胞侵入瘤内门静脉分支）的存在被认为是诊断早期HCC最重要的病理表现。典型HCC定义为使用对比增强计算机断层扫描或对比增强磁共振成像显示存在高血管病变并伴有延迟洗脱。每隔3个月进行随访检查以监测局部肿瘤进展的迹象。然后使用Kaplan-Meier方法确定病理早期HCC和典型HCC的局部肿瘤进展率。
在50例病理早期HCC的随访期间，49个结节（98%）未出现局部肿瘤进展。然而，1个结节（2%）在RFA后636天出现局部肿瘤进展。对于187例典型HCC，46个结节（24.6%）在RFA后出现局部复发。典型HCC局部肿瘤进展的随访期中位数为605天，范围为181至1741天。在典型HCC病例中，1年、2年、3年和4年时局部肿瘤进展的发生率分别为7.0%（7/187）、16.0%（30/187）、21.9%（41/187）和24.6%（46/187）。使用对数秩检验评估时，与典型HCC相比，病理早期HCC在统计学上与较低的局部肿瘤进展率相关（P = 0.002）。
病理早期HCC经RFA后的局部肿瘤进展率显著低于典型HCC。
