Toyosaka A, Okamoto E, Mitsunobu M, Oriyama T, Nakao N, Miura K
First Department of Surgery, Hyogo College of Medicine, Japan.
Am J Gastroenterol. 1996 Aug;91(8):1610-5.
The mechanism and pathogenesis of the high frequency of intrahepatic metastasis in hepatocellular carcinoma (HCC) has not yet been elucidated.
Two hundred thirty-one tumors ( < or = 5 cm in diameter) of resected specimens of HCC were examined for the relationship between mode of tumor spread and tumor size. Efferent vessels in HCC were identified by direct injection of radiopaque material into the tumor in 23 resected liver specimens selected from the 231 tumors.
The most frequent site for tumor spread in HCC was capsular invasion followed by extracapsular invasion, vascular invasion, and finally intrahepatic metastasis. Radiopaque material injected directly into 23 resected tumors entered the portal vein in only 17 tumors and entered into both the portal and hepatic veins in six tumors.
These findings suggest that tumor spread in HCC progresses from capsular invasion to intrahepatic invasion and that the portal vein may act as an efferent tumor vessel.
肝细胞癌（HCC）肝内转移高发的机制和发病原理尚未阐明。
对231例切除标本的HCC肿瘤（直径≤5厘米）进行检查，以研究肿瘤扩散方式与肿瘤大小之间的关系。从231个肿瘤中选取23个切除的肝脏标本，通过向肿瘤直接注射不透射线的物质来识别HCC中的输出血管。
HCC中肿瘤扩散最常见的部位是包膜侵犯，其次是包膜外侵犯、血管侵犯，最后是肝内转移。直接注射到23个切除肿瘤中的不透射线物质仅在17个肿瘤中进入门静脉，在6个肿瘤中进入门静脉和肝静脉。
这些发现表明，HCC中的肿瘤扩散从包膜侵犯发展到肝内侵犯，并且门静脉可能充当肿瘤输出血管。
