Kojiro M
Department of Pathology, Kurume University School of Medicine, Japan.
Hepatogastroenterology. 1998 Aug;45 Suppl 3:1203-5.
Small, early stage hepatocellular carcinoma (HCC) can be divided into 2 types; small nodular HCC with distinct margins and small HCC with indistinct margins. The latter consists of well-differentiated cancerous tissue with replacing growth at the boundary and with many portal tracts retained in the tumor. When these tumors reach approximately 1.5-2.0 cm in diameter, moderately or poorly differentiated cancer tissues develop within the well-differentiated cancer tissue and well-differentiated cancer tissues are replaced by less differentiated cancer tissues. This dedifferentiation seems to be closely related to tumor proliferation. When less differentiated cancer tissues within the well-differentiated cancer nodules proliferate in an expansive fashion, a "nodule in nodule" appearance is frequently identified. On the other hand, small nodular HCCs with distinct margins are well-defined, with more than half of them encapsulated by a thin fibrous capsule, and about 60% moderately differentiated. Tumor invasion into the portal vein and intrahepatic metastasis are found in 27% and 10%, respectively. Thus, although the size of the tumor may be small, some distinctly nodular small HCCs can already be interpreted as advanced cancers.
小的早期肝细胞癌（HCC）可分为2种类型：边界清晰的小结节型HCC和边界不清的小HCC。后者由高分化癌组织构成，边界处呈替代生长，肿瘤内保留有许多门静脉分支。当这些肿瘤直径达到约1.5 - 2.0 cm时，高分化癌组织内会出现中分化或低分化癌组织，高分化癌组织被低分化癌组织取代。这种去分化似乎与肿瘤增殖密切相关。当高分化癌结节内的低分化癌组织呈膨胀性增殖时，常可发现“结节中结节”的表现。另一方面，边界清晰的小结节型HCC边界明确，其中一半以上被薄纤维包膜包裹，约60%为中分化。门静脉侵犯和肝内转移分别见于27%和10%的病例。因此，尽管肿瘤体积可能较小，但一些边界清晰的小结节型小HCC已可被视为进展期癌症。
