Dysplastic nodule of liver versus early hepatocellular carcinoma：a clinicopathologic and prognostic study
10.3760/cma.j.issn.0529-5807.2014.05.004
- VernacularTitle:肝脏异型增生结节癌变过程的病理形态及预后分析
- Author:
Lingli CHEN
1
;
Yunshan TAN
;
Haiying ZENG
;
Yingyong HOU
;
Jianfang XU
;
Jing ZHAO
;
Yuan JI
Author Information
1. 复旦大学附属中山医院病理科
- Keywords:
Liver neoplasms;
Hyperplasia;
Prognosis
- From:
Chinese Journal of Pathology
2014;(5):301-306
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical features , pathologic findings and prognosis of patients with dysplastic nodules of liver ( DN ) and early hepatocellular carcinomas ( eHCC ).Methods One hundred and forty-five archival cases previously diagnosed as DN or eHCC or well-differentiated HCC during the period from 2000 to 2009 were retrieved and reevaluated with the new diagnostic criteria by two experienced pathologists , according to International Consensus Group for Hepatocellular Neoplasia ( ICGHN) 2008.Immunohistochemical study (EnVision method) for CD34, HSP70, glutamine synthetase, glypican 3 and Ki-67 was carried out.The original diagnosis and diagnosis after review were compared and correlated with the survival data of the patients , with statistical analysis.Results With the new criteria , 16 cases were diagnosed as low-grade DN, 50 cases as high-grade DN, 72 cases as DN with microinvasion , 7 cases as advanced HCC.Slide review showed no diagnostic discrepancy in 112 cases ( 77.2%).Amongst the 33 (22.8%) underdiagnosed cases , there were 7 cases of advanced HCC initially diagnosed as DN or DN with microinvasion and 26 cases of eHCC initially diagnosed as high-grade DN.Kaplan-Meier analysis showed that the diagnosis of high-grade DN or early HCC carried no statistically significant difference in overall survival (P=0.778, 0.677) or disease-free survival (P=0.949, 0.700) in all patients and in patients with no history of HCC.The co-existence of advanced HCC in patients with DN or eHCC significantly correlated with overall survival (P=0.004) but not with disease-free survival (P=0.079).Conclusions The new diagnostic criteria by ICGHN 2008 are useful in delineating high-grade DN and eHCC.The overall survival and disease-free survival of patients with eHCC or high-grade DN undergoing hepatectomy show no statistically significant difference.Patients with DN or eHCC have better prognosis than patients with advanced HCC , though there is still a high risk of tumor recurrence .
