Department of Pathology, Faculty of Medicine, Inonu University, Elazig Yolu 10. Km, 44280, Malatya, Turkey.
J Gastrointest Cancer. 2020 Dec;51(4):1176-1186. doi: 10.1007/s12029-020-00499-5.
Hepatocellular carcinoma is one of the most common cancers and an important health problem all over the world. Its prognosis is poor. For better patient care, early diagnosis is essential. Although new imaging techniques have a big impact on hepatocellular carcinoma diagnosis, histopathological examination is still the gold standard for precise diagnosis. Histopathological evaluation gives exact diagnosis in the meaning of tumor size, histological subtypes, grading, and differential diagnosis from metastasis and other tumors. Immunohistochemistry as a part of diagnostic histopathological technique plays an important role in routine practice. Immunohistochemistry is useful for confirming of hepatocytic origin, supporting hepatocellular malignancy, and differential diagnosis. It also gives prognostic information. There are growing attempts to classify tumors by their molecular genetic signatures. This is also actual for hepatocellular carcinoma. This mini review focuses on the histopathology of hepatocellular carcinoma including subtypes; differential diagnosis and immunohistochemistry as an ancillary diagnostic tool, updated or added entities, i.e., combined hepatocellular-cholangiocarcinoma; small hepatocellular carcinoma; correlation with molecular studies; and future perspectives.
肝细胞癌是最常见的癌症之一,也是全世界的一个重要健康问题。其预后较差。为了更好地进行患者护理,早期诊断至关重要。尽管新的成像技术对肝细胞癌的诊断有很大的影响,但组织病理学检查仍然是准确诊断的金标准。组织病理学评估在肿瘤大小、组织学亚型、分级以及与转移和其他肿瘤的鉴别诊断方面给出了确切的诊断。免疫组织化学作为诊断组织病理学技术的一部分,在常规实践中发挥着重要作用。免疫组织化学可用于确认肝细胞起源、支持肝细胞恶性肿瘤以及鉴别诊断。它还提供预后信息。人们越来越试图根据肿瘤的分子遗传特征对其进行分类。这对肝细胞癌也是适用的。这篇迷你综述重点介绍了肝细胞癌的组织病理学,包括亚型;鉴别诊断和免疫组织化学作为辅助诊断工具,更新或增加的实体,即肝细胞-胆管细胞癌;小肝细胞癌;与分子研究的相关性;以及未来展望。