Department of Pathology, Keio University School of Medicine, Tokyo 160-8582, Japan; Department of Pathology, National Hospital Organization, Tokyo Medical Center, Tokyo 152-8902, Japan.
Department of Pathology, Keio University School of Medicine, Tokyo 160-8582, Japan.
Hum Pathol. 2019 Apr;86:222-232. doi: 10.1016/j.humpath.2018.11.024. Epub 2018 Dec 28.
We investigated the clinicopathological and molecular characteristics of scirrhous hepatocellular carcinoma (HCC) to elucidate its uniqueness. Samples from 120 resected HCC cases underwent immunohistochemical analysis. Tumor area containing fibrous stroma and the percentage of steatotic cells within the tumor were evaluated. In our previous report, tumors were immunohistochemically subclassified as biliary/stem cell markers-positive (B/S) (cytokeratin 19 and/or sal-like protein 4 and/or epithelial cell adhesion molecule positive), Wnt/β-catenin signaling-related markers-positive (W/B) (β-catenin and/or glutamine synthetase positive), or all markers-negative (-/-) groups. Thirty-seven cases (31%) with fibrous stroma making up ≥50% of the largest tumor area were defined as scirrhous HCC (sHCC); the other 83 cases (69%) were categorized as common HCC (cHCC). Clinicopathologically, sHCC had fewer poorly differentiated tumors (P = .037) and a higher percentage of cases with steatosis (P = .025) than cHCC. sHCC cases were further divided into two subgroups: those with ≥5% steatotic cells (steatotic sHCC) and those with <5% steatotic cells (nonsteatotic sHCC). Hepatitis B virus infection was more frequent in nonsteatotic sHCC (P = .029), and non-B, non-C cases were more frequent in steatotic sHCC (P = .006). Steatotic sHCC tended to have a longer time to recurrence than nonsteatotic sHCC and cHCC. Most nonsteatotic sHCC cases belonged to B/S group, whereas most steatotic sHCC belonged to -/- group. The same tendency in sHCC was shown in another cohort. Distinct features were seen in steatotic and nonsteatotic sHCC, and both sHCC subgroups exhibited different clinicopathological and molecular features from cHCC. These findings support the hypothesis that sHCC is an independent entity.
我们研究了硬癌型肝细胞癌（HCC）的临床病理和分子特征，以阐明其独特性。对 120 例切除 HCC 病例的样本进行了免疫组织化学分析。评估了肿瘤区域内纤维基质的含量和肿瘤内脂肪细胞的比例。在我们之前的报告中，肿瘤通过免疫组织化学被分为胆管/干细胞标志物阳性（B/S）（细胞角蛋白 19 和/或 Slp4 和/或上皮细胞黏附分子阳性）、Wnt/β-catenin 信号相关标志物阳性（W/B）（β-catenin 和/或谷氨酰胺合成酶阳性）或所有标志物阴性（-/-）组。37 例（31%）纤维基质占最大肿瘤面积的≥50%被定义为硬癌型 HCC（sHCC）；其余 83 例（69%）归类为普通 HCC（cHCC）。临床病理上，sHCC 中分化程度较低的肿瘤较少（P =.037），脂肪变性的比例较高（P =.025）。sHCC 病例进一步分为两个亚组：有≥5%脂肪变性细胞的（脂肪变性 sHCC）和有<5%脂肪变性细胞的（非脂肪变性 sHCC）。非脂肪变性 sHCC 中乙型肝炎病毒感染更为常见（P =.029），而非 B、非 C 病例在脂肪变性 sHCC 中更为常见（P =.006）。脂肪变性 sHCC 的复发时间长于非脂肪变性 sHCC 和 cHCC。大多数非脂肪变性 sHCC 病例属于 B/S 组，而大多数脂肪变性 sHCC 属于-/-组。在另一个队列中也观察到了 sHCC 的相同趋势。脂肪变性和非脂肪变性 sHCC 具有不同的特征，两组 sHCC 亚组的临床病理和分子特征与 cHCC 不同。这些发现支持 sHCC 是一个独立实体的假说。
