Comparison of the proliferative capacity of adenomatous hyperplasia and well differentiated hepatocellular carcinoma.

The identification of nodular lesions, which used to be difficult to differentiate from well differentiated hepatocellular carcinomas, has become frequent since the advent of ultrasonic-guided liver tumor biopsy techniques. This is because adenomatous hyperplasias, which are regarded as putative precancerous lesions, which needed to be differentiated from malignant lesions, often an a nodular. The histological specimens of 52 tumors, obtained from patients with chronic liver injury, were subjected to immunohistological staining for proliferative cell nuclear antigen (PCNA). Findings obtained by this immunohistological technique were compared with those obtained by histological image analysis. Adenomatous hyperplasias with fatty changes or with a high nuclear cytoplasmic ratio on image analysis were frequently PCNA-positive (P < 0.01). These nodular lesions, whose morphological characteristics were similar to those of well differentiated hepatocellular carcinomas, showed a high potential for growth. It seems that PCNA may be a useful indicator for increasing our understanding of the progress from adenomatous hyperplasia to hepatocellular carcinoma.