摘要
目的:检测肝癌亚临床转移灶并探讨其临床病理学意义。方法:采用病理大切片技术检测55例肝癌手术切除标本瘤外肝实质内亚临床转移灶;LSAB(Labelledstreptavidin-biotin)免疫组织化学染色检测肝癌微血管密度。结果:全组36例(65.5%)瘤外肝组织内存在亚临床转移灶。肝癌亚临床转移灶与年龄、性别、AFP浓度、Edmondson分级、HBsAg等无关(P>0.05)。肿瘤无包膜或包膜不完整、大于3cm、微血管密度高者亚临床转移灶多见。亚临床转移灶距原发肿瘤边缘的最大距离超过1cm者为42.0%(15/36),超过1.8cm者为8.0%(3/36),最远者达3.5cm。有亚临床转移灶者术后复发率(69.4%)较无亚临床转移灶者(29.4%)高(P<0.05)。有亚临床转移灶者术后1、2年生存率分别为72.2%和50.0%,无亚临床转移灶者分别为84.2%和57.9%,但两者之间的差别无统计学意义(P>0.05)。有亚临床转移灶者术后1、2年无瘤生存率(52.8%,33.3%)较无亚临床转移灶者(94.7%,63.2%)低(P<0.01)。结论:肝癌亚临床转移灶的发生率较高,肿瘤内丰富的新生微血管是肿瘤发生肝内亚临床转移的重要途径之一。病理大切片检测肝癌手术标本内亚临床转移灶可能是预测肝癌预后重要的病理学指标。
Objective:To study the clinicopathological significance of micrometastasis in hepatocellular carcinoma (HCC).Methods:Tumor micrometastasis in55cases of HCC were tested with gross pathological section technique and tumor microvessel density(MVD)was tested by immunohistochemical staining(LSAB).Results:Thirty-six out of55patients were identified with tumor micrometastasis in peritumor parenchyma.Tumor micrometastasis had no significant correlation with age,sex,serum alpha-fetoprotein concentration,Edmondson-Steiner's classifica-tion and hepatitis B virus(HbsAg)infection.The tumor usually had no intact capsule or no cap-sule.It was often seen in tumors of greater than3cm in size and with hypermicrovessel density.The farthest distance from the primary tumor to the focus of micrometastasis more than1cm was42%(15/36),1.8cm was8%(3/36)and even to3.5cm in one case.The recurrence rate in cases with or without micrometastasis were69.4%and29.4%respectively(P<0.05).The1-,2-year survival rates were72.5%and50.0%respectively in cases with micrometastasis,and84.2%and57.9%respectively in those without micrometastasis.The difference of survival rates between these two groups had no statistical saignificance(P>0.05).The1-,2-year disease-free survival rates in patients with micrometastasis(52.8%,33.3%)were lower than those without micrometas-tasis(94.7%,63.2%)(P<0.01).Conclusion:There is a high incidence of tumor micrometastasis in HCC.The abundant microvessel density in primary tumor plays a critical role in intrahepatic micrometastasis.Testing tumor micrometastases in resected samples with gross pathological tech-nique may be an important prognostic indicator to predict postoperative intrahepatic recurrence in HCC.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2002年第2期77-81,共5页
Chinese Journal of Clinical Oncology
基金
国家科委"九五"攻关项目基金资助(编号:96-907-03-02)
关键词
肝肿瘤
肝切除术
亚临床转移灶
微血管密度
Liver neoplasm Pathology Hepatectomy Micrometastasis Microvessel density
