Caturelli E, Fusilli S, Costarelli L, Bosman C, Squillante M M, Andriulli A, Cellerino C, Pompili M, Rapaccini G L
Divisione di Gastroenterologia, Casa Sollievo della Sofferenza San Giovanni Rotondo, Foggia, Italy.
J Clin Gastroenterol. 1993 Jul;17(1):67-72. doi: 10.1097/00004836-199307000-00017.
Ten cirrhotic patients with ultrasonically discernible focal liver masses underwent fine cutting needle biopsy. Specimens were obtained from the focal lesions under ultrasound guidance and histologically diagnosed as regenerative nodules. An image analyzer was then used to determine the cytoplasmic area, nuclear area, and nuclear/cytoplasmic ratio for 100 randomly selected cells from each specimen. Data were then compared with data for specimens of normal liver tissue and data from patients with alcoholic or posthepatic cirrhosis or well-differentiated hepatocellular carcinoma (HCC). The morphometric parameters for the group of regenerative nodule specimens fell within an intermediate range between those for HCC and the nondysplastic samples, strongly suggesting a preneoplastic nature. Nine of the 10 regenerative lesions showed liver cell dysplasia, and 3 of these patients developed HCC during follow-up. Ultrasonically discernible focal masses in a cirrhotic liver should be considered preneoplastic, if not neoplastic lesions and treated aggressively to prevent their progression to outright malignancy.
十名患有超声可识别的肝脏局灶性肿块的肝硬化患者接受了细针切割活检。在超声引导下从局灶性病变获取标本，并经组织学诊断为再生结节。然后使用图像分析仪确定每个标本中随机选择的100个细胞的细胞质面积、细胞核面积和核质比。然后将数据与正常肝组织标本的数据以及酒精性或肝后性肝硬化患者或高分化肝细胞癌（HCC）患者的数据进行比较。再生结节标本组的形态计量学参数介于HCC和非发育异常样本之间的中间范围内，强烈提示其肿瘤前性质。10个再生性病变中有9个显示肝细胞发育异常，其中3名患者在随访期间发展为HCC。肝硬化肝脏中超声可识别的局灶性肿块即使不是肿瘤性病变，也应被视为肿瘤前病变，并积极治疗以防止其发展为完全恶性肿瘤。
