In the 21st century, the concept of traditional "gold standard" of pathological diagnosis may be renewed, the improved methods will reflect the overall diagnostic levels of morphological pathology, immunopathology, and molecular pathology as a whole. Therefore, the accuracy and reliability of the improved methods will reach a new level. The clinical application of molecular pathology will make the connotation of classical pathological diagnosis much wider, and will provide multiple valuable information for evaluating the nature of lesions, biological characters, their response to therapy, clinical prognosis and so on at a molecular level. To establish a disease-related specific molecular profiling and a low-cost, standardized and automatic technique are key points for the development of molecular pathology in the future.

DNA content of 38 hepatocellular carcinomas (HCC) was quantitatively determined by means of image analysis technology .The results showed that DNA content in HCC was correlated well with the tumor size, capsule breaking, cancerous thrombus forming and clinical prognosis, that is, the higher DNA content was, the more malignance appeared, but not with the clinical staging and pathological grading of HCC. 66.7% of DNA diploid/near diploid HCC were less than or equal to 3cm in diameter, whereas 75% of DNA aneuploid HCC were more than 3cm in diameter (P

Seven cellular parameters in adenomatous hyperplasia of the liver (AHL), compared with normal liver cells (NLC) and hepatocellular carcinoma (HCC), were analyzed quantitatively by measuring the seven parameters of the cell nuclei, the area (AREA), perimeter (PERIM), maximum diameter (DMAX), minimum diameter (DMIN), the equivalent circle diameter (DCIRCLE), circularity shape factor (FCIRCLE) and shape factor (FSHAPE) using computerized image analyzer. The main results were: (1) All the above seven nuclear parameters in AHL were significantly different from those in NLC, three parameters (DMAX, DMIN and FSHAPE) in AHL were not obviously different from those in HCC, indicating that AHL and NLC were not of the same cellular population, and AHL had a tendency of approaching HCC in the nuclear features; (2) Not alike NLC and HCC, the scattered distribution between nuclear FCIRCLE and DCIRCLE in AHL presented a highly dispersed distribution, overlapping the areas of NLC and the greater part of HCC, suggesting that AHL being an abnormal cellular population composed of cells in different proliferative status between NLC and HCC; (3) All of five resected AHL in the present study showed early malignant transformation. We conclude that AHL possesses the general features of precancerous lesion, and should be considered as the important precancerous lesion of HCC.

Surgical-oncological pathology is one of the most important supporting discipline for hepatobiliary surgery.With rapid development in modern hepatobiliary surgery,the traditional model of morphological diagnosis can no longer meet the needs of oncological surgery.To improve the level of pathological diagnosis, better understand clinical concerns,update the mode of pathological diagnosis,introduce new technologies,expand the connotations of pathological diagnosis,provide a new indexing system for clinical treatment programs,and focus on interdisciplinary collaborative research are the most important issues in the development of surgical pathology for hepatobiliary tumors.

Objective:To study the clinicopathological and immunohistochemical features of hepatic malignant vascular tumors. Methods:H E and immunohistochemistry were used to study 6 angiosarcoma and 5 epithelioid hemangioendothelioma (EHE) of the liver. Patients were aged 0.5 68 years, 7 were females and 4 were males. Results:Patients presented with nonspecific symptoms. Macroscopically,the tumors were usually multiple (3 13.7 cm in diameter) and were frequently hemorrhagic and multinodular. Histologically,there was a wide morphologic spectrum among cases. Six angiosarcoma included areas similar to cavernous and capillary hemangioma,spindle cell and epithelioid sarcoma. In the hepatic EHE,the tumor were comprised of dendritic and epithelioid cells that often contained vacuoles representing intracellular lumina. The stroma was fibrous with myxohyaline areas. Immunohistochemically,all tumors were positive for at least one endothelial marker(factor Ⅷ related antigen and /or CD 34 ). Conclusion:Hepatic malignant vascular tumor is very rare, the angiosarcoma of the liver is highly malignant with short survival. The prognosis of EHE is usually much better than that of angiosarcoma, surgical resection can obtain prolonged survival. The diagnosis can be made based on histological and immunohistochemical features of the tumor.

Early detection and treatment of hepatocellular carcinoma (HCC) is one of the most direct and effective ways to improve the long-term outcome of patients with HCC. The comparative study on clinicopathological characteristics of surgically resected micro HCC (≤1 cm), small HCC(≤3 cm), middle HCC (3-5 cm), and large HCC (>5 cm) showed that ≤3 cm small HCC had the features of DNA diploidy, well differentiation, relatively slow growth, encapsulation, rare long-distance metastatic foci and thrombosis, easy to be radically resected and long-term postoperative survival. It is suggested that HCC growing to about ≤3 cm is an important growth phase when the change of pathobiological characteristics of HCC from a relatively benign to a more malignant behavior would occur. This is also the important time to carry out radical treatment to get better results. Therefore,further research on the early diagnosis and treatment as well as the pathobiological features of small HCC ≤3 cm should be undertaken as one of the key clinical and pathological studies in the future.

Multinolular and intrahepatic recurrent HCC can originate from intrahepatic metastasis and multiple origins,and their colnal origin is closely related to the clinical diagnosis and treatment.To designate suitable therapeutic strategies according to their colnal origin is a new challenge needs to be tackled urgently.This paper reviews recent progress in the clinicopathological features,molecular diagnosis and clinical outcomes of multiple origin HCC.

10 000 : 1, the scoring might result in misleading conclusions. The concentration of genomic DNA-PCR reaction products in 50 ng/fd was suitable for CEA analysis. Conclusion: The concentration of PCR reaction residues in CEA system is one of the key factors altering genotyping results.

To study the immunopathological characteristics and differential diagnosis of hepatic angiomyolipoma(AML).Methods:Thirty-six surgically resected hepatic AML were investigated clinicopathologically and immunohistochemically with 10 antibodies.Results:Hepatic AML occurred in 21 females and 15 males,with the mean age of 41.6 years(26-60 years old).The patients with AML often had no special symptoms even had large space-occupying lesions in the liver.The diameter of AML was 2.5 cm to 14 cm(mean 6.8 cm).Histologically,AML was composed of varying heterogeneous mixture of 3 tissue components:blood vessels,smooth muscle and adipose cells.Extramedullary hemopoiesis sometimes existed.According to tissue components,AML was subcategorized into mixed type(19.4%,n=7),lipomatous type(11.1%,n=4),myomatous type(66.7%,n=24),and angiomatous type(2.8%,n=1).The epithelioid smooth muscle cells were sensitive to HMB-45(100%),SMA(100%),and CD117(66.7%) staining.Conclusion:Hepatic AML often contains smooth muscle elements,which have varied morphological features and should be carefully differentiated from hepatocellular carcinoma,mesenchymal hamartoma，and tumors with rich fat or blood vessels.Immunohistochemical staining with HMB-45 and SMA are the best available markers for the diagnosis of hepatic AML.

Carcinoma, Hepatocellular ; diagnosis ; surgery ; therapy ; Hepatectomy ; Humans ; Liver Neoplasms ; diagnosis ; surgery ; therapy