Saler C H A, Shuai S, Beckervordersandforth J C, Rennspiess D, Roemen G, Gevers T, Stoehr-Kleinegris M C F, Bouwense S A W, Dewulf M J L, Coolsen M M E, Bemelmans M H A, Damink S W Olde, Winnepenninckx V, Hausen A Zur, Kramer M, Samarska I V
Department of Pathology, GROW-School for Oncology and Reproduction, Maastricht University Medical Center +, Maastricht, the Netherlands.
Department of Internal Medicine, GROW-School for Oncology and Reproduction, Maastricht University Medical Center +, Maastricht, the Netherlands.
Cancer Rep (Hoboken). 2025 Feb;8(2):e70127. doi: 10.1002/cnr2.70127.
We aimed to analyze hepatocellular carcinoma (HCC) morphological subtypes characterized according to the WHO classification and the International Collaboration on Cancer Reporting (ICCR) recommendations, and their prognostic features in a Dutch population.
This retrospective study in a tertiary referral center included the histopathological revision of 62 HCC resection specimens, obtained from 22 female and 40 male patients (median age: 67 years), in a period between 2011 and 2021 at the Maastricht University Medical Center +. Clinical data, morphological subtypes, growth pattern (GP), tumor grade, tumor extension, margins, and vascular and perineural invasion were collected. Eighteen cases were assigned a specific morphologic subtype and steatohepatic HCC was the most common in our cohort. Twenty-one tumors classified as conventional type HCC (HCC-NOS), commonly exhibiting two concurrent GPs. Twenty-three cases revealed a heterogeneous morphologic differentiation, compromising the combination of HCC-NOS with another morphologic subtype, most frequently a steatohepatitic component. Comparison of HCC-NOS and HCC with heterogeneous morphology did not show significant differences in the main clinicopathological characteristics and survival.
Although the most common morphologic subtype was steatohepatitic HCC, the majority of cases demonstrated multiple morphologic patterns. In case of HCC-NOS, heterogeneous GPs were often observed. Therefore, a histomorphological diagnosis based on a single tumor biopsy specimen may lead to incorrect classification of HCC. Sufficient tumor sampling of HCC resection specimens is required for the complete evaluation of all histomorphological features followed by correct subclassification in order to meet the clinical needs regarding prognostic relevance and patient follow-up.
我们旨在分析根据世界卫生组织（WHO）分类和国际癌症报告协作组织（ICCR）建议所界定的肝细胞癌（HCC）形态学亚型，及其在荷兰人群中的预后特征。
这项在三级转诊中心开展的回顾性研究纳入了62例HCC切除标本的组织病理学复查，这些标本取自2011年至2021年期间在马斯特里赫特大学医学中心+的22例女性和40例男性患者（中位年龄：67岁）。收集了临床数据、形态学亚型、生长模式（GP）、肿瘤分级、肿瘤范围、切缘以及血管和神经周围侵犯情况。18例被归为特定形态学亚型，脂肪性肝炎型HCC是我们队列中最常见的类型。21个肿瘤被归类为传统型HCC（HCC-NOS），通常表现出两种并存的生长模式。23例显示出形态学分化异质性，即HCC-NOS与另一种形态学亚型（最常见的是脂肪性肝炎成分）的组合。HCC-NOS与形态学异质性HCC在主要临床病理特征和生存率方面的比较未显示出显著差异。
尽管最常见的形态学亚型是脂肪性肝炎型HCC，但大多数病例表现出多种形态学模式。在HCC-NOS病例中，常观察到生长模式异质性。因此，基于单个肿瘤活检标本的组织形态学诊断可能导致HCC分类错误。为了满足关于预后相关性和患者随访的临床需求，需要对HCC切除标本进行充分的肿瘤取样，以全面评估所有组织形态学特征，随后进行正确的亚分类。
