Sugitani S, Sakamoto M, Ichida T, Genda T, Asakura H, Hirohashi S
Pathology Division, National Cancer Center Research Institute, Tokyo, Japan.
J Hepatol. 1998 Jun;28(6):1045-53. doi: 10.1016/s0168-8278(98)80355-3.
BACKGROUND/AIMS: Identification of the risk factors of multicentric hepatocarcinogenesis is important for the clinical management of hepatocellular carcinoma. We investigated hyperplastic foci in non-cancerous liver parenchyma, and clarified their pathological features and clinical significance.
Hyperplastic foci were defined as hypercellular areas, which architecturally and cytologically resembled early hepatocellular carcinoma or adenomatous hyperplasia but did not form macroscopically detectable nodules. Surgically resected livers from 155 patients with hepatocellular carcinoma were examined histopathologically and immunohistochemically.
Hyperplastic foci were found in 26 of 155 patients (16.8%). All the patients with hyperplastic foci had chronic liver diseases, and the incidence did not differ between those with chronic hepatitis and those with liver cirrhosis. Six of 92 (6.5%) patients with single primary hepatocellular carcinoma nodules, 8 of 42 (19.0%) with two nodules, and 12 of 21 (57.0%) with more than three nodules had hyperplastic foci. The incidence of hyperplastic foci showed a significant positive correlation with the multiplicity of hepatocellular carcinoma nodules. Immunohistochemically, hyperplastic foci were masses of proliferative hepatocytes similar to adenomatous hyperplasia and early hepatocellular carcinoma.
Hyperplastic foci reflect the risk of multicentric hepatocarcinogenesis. Our results suggest strongly that hyperplastic foci are precursors of adenomatous hyperplasia or hepatocellular carcinoma.
背景/目的：确定多中心肝癌发生的危险因素对于肝细胞癌的临床管理很重要。我们研究了非癌性肝实质中的增生灶，并阐明了它们的病理特征和临床意义。
增生灶定义为细胞增多区域，其在结构和细胞学上类似于早期肝细胞癌或腺瘤样增生，但未形成肉眼可检测到的结节。对155例肝细胞癌患者手术切除的肝脏进行组织病理学和免疫组织化学检查。
155例患者中有26例（16.8%）发现增生灶。所有有增生灶的患者均患有慢性肝病，慢性肝炎患者和肝硬化患者的发生率无差异。92例单发原发性肝细胞癌结节患者中有6例（6.5%）、42例有两个结节的患者中有8例（19.0%）、21例有三个以上结节的患者中有12例（57.0%）有增生灶。增生灶的发生率与肝细胞癌结节的多发性呈显著正相关。免疫组织化学显示，增生灶是类似于腺瘤样增生和早期肝细胞癌的增殖性肝细胞团块。
增生灶反映了多中心肝癌发生的风险。我们的结果强烈提示增生灶是腺瘤样增生或肝细胞癌的前体。
