微卫星分析复发病灶证实解剖性肝切除术治疗肝细胞癌的优势。
Microsatellite Analysis of Recurrent Lesions Confirms Merit of Anatomical Liver Resection for Hepatocellular Carcinoma.
机构信息
Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan.
出版信息
Anticancer Res. 2019 Aug;39(8):4315-4324. doi: 10.21873/anticanres.13597.
BACKGROUND/AIM: This study aimed to obtain accurate differential diagnosis (DDx) of multicentric carcinogenesis (MC) and intrahepatic metastasis (IM) in recurrent lesions of hepatocellular carcinoma.
MATERIALS AND METHODS
A total of 79 patients who underwent re-hepatectomy (2000-2013) were examined. PCR was used to analyze 13 chromosomal microsatellite loci by PCR. On the basis of this genetic analysis, the recurrent lesions were diagnosed as IM, MC or not determined (ND). Subsequently, DDx was compared with types of resection and outcome.
RESULTS
The recurrent lesions were diagnosed as IM in 33 patients, MC in 44, and ND in 2. The anatomical resection group included 14 IM lesions (28%) and 36 MC lesions (72%), while the non-anatomical resection group included 19 IM lesions (70%) and 8 MC lesions (30%) (p<0.001).
CONCLUSION
Anatomical resection at initial hepatectomy may reduce the likelihood of IM recurrence, leading to a better outcome for patients with HCC.
背景/目的：本研究旨在对复发性肝细胞癌的多中心性发生（MC）和肝内转移（IM）进行准确的鉴别诊断（DDx）。
材料和方法
共检查了 79 例接受再次肝切除术（2000-2013 年）的患者。采用 PCR 检测 13 个染色体微卫星位点。在此遗传分析的基础上，将复发性病变诊断为 IM、MC 或未确定（ND）。随后，比较了 DDx 与切除类型和结果。
结果
复发性病变被诊断为 IM 的有 33 例，MC 的有 44 例，ND 的有 2 例。解剖性切除术组包括 14 例 IM 病变（28%）和 36 例 MC 病变（72%），而非解剖性切除术组包括 19 例 IM 病变（70%）和 8 例 MC 病变（30%）（p<0.001）。
结论
初始肝切除时的解剖性切除可能降低 IM 复发的可能性，从而改善 HCC 患者的预后。
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