Uchida T
Department of Pathology, Nihon University School of Medicine, Tokyo, Japan.
Pathol Int. 1995 Mar;45(3):175-84. doi: 10.1111/j.1440-1827.1995.tb03440.x.
Recent advances in imaging techniques have led to the discovery of small hepatocellular carcinomas (HCC). The small HCC most often exhibit low-grade malignant (LGM) or extremely well differentiated features, which are different from those of advanced, full-blown HCC. The LGM-HCC present a serious diagnostic challenge to pathologists and must be differentiated from benign (reactive) and atypical (borderline) hyperplastic nodules. Analysis of small HCC revealed that hepatocarcinogenesis frequently occurs stepwise from atypical hyperplasia to LGM-HCC and subsequently to advanced HCC. The HCC arise in irregular regeneration in chronic liver disease and in the essentially normal liver after steroid administration. Although the tumor suppressor gene, p53, is revealed to be often mutated in advanced HCC, the genetic events corresponding to each stage of multistep hepatocarcinogenesis are not clarified at all.
成像技术的最新进展已促使小肝细胞癌（HCC）被发现。小肝细胞癌通常表现出低级别恶性（LGM）或高分化特征，这与进展期、典型的肝细胞癌不同。LGM-HCC给病理学家带来了严峻的诊断挑战，必须与良性（反应性）和非典型（临界）增生性结节相鉴别。对小肝细胞癌的分析显示，肝癌发生常常是逐步从非典型增生发展为LGM-HCC，随后进展为进展期肝癌。肝细胞癌在慢性肝病的不规则再生中以及在给予类固醇后基本正常的肝脏中发生。虽然肿瘤抑制基因p53在进展期肝癌中常常发生突变，但多步骤肝癌发生各阶段对应的基因事件根本尚未明确。
