Relationship between microvessel count and post-hepatectomy survival in patients with hepatocellular carcinoma

Abstract

AIM:To elucidate the relationship between the microvessel count (MVC) by CD34 analyzed by immunohistochemical method and prognosis in h e p a t o c e l l u l a r c a r c i n o m a ( H C C ) p a t i e n t s w h o underwent hepatectomy based on our preliminary study. METHODS:We examined relationships between MVC and clinicopathological factors in 128 HCC patients. The modified Japan Integrated Staging score (mJIS) was applied to examine subsets of HCC patients. RESULTS: Median MVC was 178/mm 2 , which was used as a cut-off value. MVC was not significantly associated with any clinicopathologic factors or postoperative recurrent rate. Lower MVC was associated with poor disease-free and overall survivals by univariate analysis (P = 0.039 and P = 0.087, respectively) and lower MVC represented an independent poor prognostic factor in disease-free survival by Cox's multivariate analysis (risk ratio, 1.64; P = 0.024), in addition to tumor size, vascular invasion, macroscopic finding and hepatic dysfunction. Significant differences in diseasefree and overall survivals by MVC were observed in HCC patients with mJIS 2 (P = 0.046 and P = 0.0014, respectively), but not in those with other scores. CONCLUSION: Tumor MVC appears to offer a useful prognostic marker of HCC patient survival, particularly in HCC patients with mJIS 2.

Selecting treatment for hepatocellular carcinoma based on the results of hepatic resection and local ablation therapy

“…However, such patients would be considered for less invasive and locally radical treatments such as hepatectomy and ablation therapy in Japan [5,18,19]. As we have previously reported, post-treatment survival following hepatectomy or ablation with a modified Japan integrated staging (JIS) score of 0-2 is satisfactory compared to the results of living donor liver transplantation in Japan [20]. Although survival results following liver transplantation might be totally superior in comparison with local treatments [13], the majority of HCC patients cannot undergo liver transplantation under the situation of low numbers of cadaveric donor in Japan and some post-operative complications have been encountered in living donors after this modality [21,22].…”

“…In the present result, tumor recurrence rates after treatment were not significantly different under any situation between groups. However, the location of tumor recurrence might differ with each treatment [20,29,30]. Although we could not examine the pattern of tumor recurrence in all cases, our preliminary result showed that tumor recurrence in the treated part among patients who underwent ablation therapy was remarkable in comparison with that in patients with hepatectomy [20].…”

“…However, the location of tumor recurrence might differ with each treatment [20,29,30]. Although we could not examine the pattern of tumor recurrence in all cases, our preliminary result showed that tumor recurrence in the treated part among patients who underwent ablation therapy was remarkable in comparison with that in patients with hepatectomy [20]. In the hepatectomy group, distantly intra-hepatic metastasis or multi-centric carcinogenesis would affect tumor recurrence, as treatment-site recurrence might be rare after hepatectomy in our series given that we always attempt a 1-to 2-cm surgical margin to resect minute satellite lesions in a curative operation [31].…”

Pelioid-type well-differentiated hepatocellular carcinoma in a patient with a history of taking oral contraceptives: Report of a case

“…CD34 is expressed in the endothelium of common HCC and in the dilated sinusoids in our case, but is not expressed in PCs. 19 This is compatible with the parenchymal type of peliosis hepatis 9 and may mean that pelioid-type HCC shows intermediate features between common HCC and parenchymal peliosis hepatis. Through Victoria-Blue as well as hematoxylin-eosin staining, we were able to identify stromal invasion and diagnose this tumor as well-differentiated HCC.…”

Down-regulation of artery in moderately differentiated hepatocellular carcinoma related to tumor development

“…Previous studies have reported on the relationship between intratumoral vessel densities in HCC and clinicopathological findings evaluated by endothelial cell markers (CD34 and factor VIII) [10][11][12][13] and smooth muscle cell markers (α-smooth muscle actin and calponin) [14,15]. However, to the best of our knowledge, there have been no reports on the arterial vasculature of moderately differentiated HCC, which is the transitional stage of arterial blood supply from well-differentiated HCC to poorly differentiated HCC.…”