The formation of capsule and septum in human hepatocellular carcinoma

Ishizaki, Masahiko; Ashida, Kozo; Higashi, Toshihiro; Nakatsukasa, Harushige; Kaneyoshi, Toshihiko; Fujiwara, Keishi; Nouso, Kazuhiro; Kobayashi, Yohnosuke; Uemura, Masayuki; Nakamura, Shinichiro; Tsuji, Takao

doi:10.1007/s004280000391

Cited by 67 publications

(45 citation statements)

References 20 publications

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“…A fibrous capsule in HCC has been considered a favourable prognostic factor, because the capsule may prevent invasion of HCC to the adjacent liver parenchyma [23][24][25]. However, Adachi et al [26] reported that the blood vessels of the fibrous capsule were frequently invaded by cancer cells and stated that the presence of a fibrous capsule is a predictor of portal venous invasion.…”

Section: Discussionmentioning

confidence: 99%

Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

Rc²,

Cw³

et al. 2012

BJR

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Objective: The aim of this study was to diagnose microvascular invasion in patients with solitary hepatocellular carcinoma (HCC) from pre-operative CT imaging. Methods: 102 patients with solitary HCC who underwent curative hepatectomy were retrospectively included in our study. The pre-operative 3-phase CT imaging and laboratory data for the 102 patients were reviewed. Tumour size, tumour margin, peritumoral enhancement and a-fetoprotein level were assessed. Surgical pathology was reviewed; tumour differentiation, liver fibrosis score and microvascular invasion were recorded. Results: The histopathological results revealed that 50 HCCs were positive and the other 52 were negative for microvascular invasion. Univariate analysis revealed that tumour size (p50.036), higher Edmondson-Steiner grade (p50.047) and non-smooth tumour margin (p,0.001) showed statistically significant associations with microvascular invasion. Multivariate logistic regression analysis showed that non-smooth tumour margin had a statistically significant association with microvascular invasion only (p,0.001). The sensitivity, specificity, positive predictive value and negative predictive value of the non-smooth tumour margin in the prediction of microvascular invasion were 66%, 86.5%, 82.5% and 72.6%, respectively. Conclusion: Non-smooth tumour margin in pre-operative CT had a statistically significant association with microvascular invasion. More aggressive treatment should be considered in HCC patients with suspected positive microvascular invasion. Hepatic resection is a potentially curative treatment modality for patients with hepatocellular carcinoma (HCC) [1][2][3][4]. Histopathological vascular tumour invasion is a well-known major prognostic factor for patients with HCC who have undergone hepatic resection or liver transplantation [5][6][7][8]. Iwatsuki et al [9] reported that microvascular and macrovascular invasions were associated with a 4.4-and 15-fold increased risk of recurrence, respectively, for patients who had undergone liver transplantation. Because microvascular tumour invasion has a significant impact on recurrence and prognosis, preoperative diagnosis of microvascular invasion is needed.Radiological detection of microvascular tumour invasion may facilitate the pre-operative prediction of a patient's prognosis. Many researchers have tried to elucidate microvascular invasion based on pre-operative imaging studies, including CT during hepatic angiography, dynamic MRI and superparamagnetic iron oxideenhanced MRI [10][11][12][13]. However, radiological findings suggestive of microvascular invasion in pre-operative CT have not yet been well established. The purpose of our study was to diagnose microvascular invasion in patients with solitary HCC from pre-operative triphasic CT findings. Methods and materials PatientsApproval for retrospective study was obtained from our institutional review board. Between January 2007 and December 2009, 153 patients with HCC who underwent elective curative hepatectomy in our institution were...

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Section: Discussionmentioning

confidence: 99%

Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

Rc²,

Cw³

et al. 2012

BJR

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“…These differences are not discussed in detail in the current literature, perhaps due to the lack of patients having HCC without cirrhosis [2,16,23,44]. Recent advances in DNA sequencing technology and the development of gene expression arrays have provided more powerful tools to study the expression of thousands of genes in HCC in a single experiment [9,21,31].…”

Section: Distinct Hepatocarcinogenic Pathways In Hcc With or Without mentioning

confidence: 97%

Genes involved in hepatocellular carcinoma: deregulation in cell cycling and apoptosis

Tannapfel

Wittekind

2002

Virchows Arch

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Hepatocellular carcinoma (HCC) accounts for 80-90% of liver cancers and is one of the most frequent carcinomas throughout the world. The disease is more prevalent in parts of Africa and Asia than in North and South America and Europe, with a strong etiological association with viral hepatitis, hemochromatosis, known liver (hepatic) carcinogens, and toxins (mycotoxins). Clinical and molecular medical analyses have yielded a considerable amount of information about liver carcinogenesis. Many genes undergo somatic aberrations, with a tendency to cluster at genes involved in cell cycle regulation, in the p53 and Wnt/catenin pathways of signal transduction and cellular adhesion, and in the TGF-beta/IGF axis. Since HCC may arise both in liver cirrhosis and in noncirrhotic liver, one may speculate that different hepatocarcinogenetic pathways exist. Recent results of high-output gene analysis using cDNA microarrays support the idea of different genetic alterations in HCC with or without cirrhosis.

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“…The rim of enhancement does not always represent a true tumor capsule and may instead represent a pseudocapsule, thought to result from perilesional compressed liver tissue. The distinction between true tumor capsule and pseudocapsule cannot be made definitely by imaging (78), but only at pathologic evaluation (78)(79)(80)(81)(82). This is why LI-RADS favors the terms "capsule" or capsule appearance.…”

Section: Washout Appearancementioning

confidence: 99%

“…The fibrous and/ or prominent sinusoidal components of the "capsule," with their expanded extracellular space, likely contribute to fibrous tissue (collagen), prominent sinusoids, and/or compressed liver parenchyma at histopathologic examination (78)(79)(80)(81)(82). In a radiology-pathology study by Ishigami et al (78) 15 of 106 of HCCs (14.2%) had a capsule appearance at imaging that did not correlate to a true fibrous capsule at histopathologic examination.…”

Section: Review: Li-rads Major Features For Hepatocellular Carcinoma mentioning

confidence: 99%

Evidence Supporting LI-RADS Major Features for CT- and MR Imaging–based Diagnosis of Hepatocellular Carcinoma: A Systematic Review

et al. 2018

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The Liver Imaging Reporting and Data System (LI-RADS) standardizes the interpretation, reporting, and data collection for imaging examinations in patients at risk for hepatocellular carcinoma (HCC). It assigns category codes reflecting relative probability of HCC to imaging-detected liver observations based on major and ancillary imaging features. LI-RADS also includes imaging features suggesting malignancy other than HCC. Supported and endorsed by the American College of Radiology (ACR), the system has been developed by a committee of radiologists, hepatologists, pathologists, surgeons, lexicon experts, and ACR staff, with input from the American Association for the Study of Liver Diseases and the Organ Procurement Transplantation Network/United Network for Organ Sharing. Development of LI-RADS has been based on literature review, expert opinion, rounds of testing and iteration, and feedback from users. This article summarizes and assesses the quality of evidence supporting each LI-RADS major feature for diagnosis of HCC, as well as of the LI-RADS imaging features suggesting malignancy other than HCC. Based on the evidence, recommendations are provided for or against their continued inclusion in LI-RADS.q RSNA, 2017 Online supplemental material is available for this article.An Tang REVIEW: LI-RADS Major Features for Hepatocellular Carcinoma DiagnosisTang et al selection of five major features was based on expert opinion, the literature review was performed to ensure that imaging-based diagnostic criteria were able to achieve near-100% specificity for the noninvasive diagnosis of HCC. This review focused on the evidence supporting the inclusion of imaging features and did not attempt to gather evidence on the composition of the LI-RADS diagnostic algorithm and probability of HCC for different combinations of criteria (other than the hallmark combination of APHE and washout appearance) in the LI-RADS diagnostic table.Each subgroup was charged with developing key research questions and then critically reviewing the literature to answer research questions thematically related to its assigned topic. Search StrategyThe PICO (patient population, intervention, comparison, and outcome) format frequently used in structured reviews does not lend itself well to studies of diagnostic performance. Rather than using PICO-style questions to guide the searches, therefore, the subgroups formulated free-form questions in advance with feedback from the other subgroups. A total of 10 questions were formulated under the framework and with the understanding that their answers would inform recommendations for removing or continuing to include the corresponding LI-RADS features. After the questions were formulated, each subgroup searched the PubMed develop a standardized Liver Imaging Reporting and Data System (LI-RADS) for interpretation, reporting, and data collection of imaging studies in patients at risk for developing HCC (1). The committee was composed mainly of diagnostic radiologists, but also hepatologists, surgeons, patho...

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The formation of capsule and septum in human hepatocellular carcinoma

Cited by 67 publications

References 20 publications

Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

Prediction of microvascular invasion of hepatocellular carcinoma by pre-operative CT imaging

Genes involved in hepatocellular carcinoma: deregulation in cell cycling and apoptosis

Evidence Supporting LI-RADS Major Features for CT- and MR Imaging–based Diagnosis of Hepatocellular Carcinoma: A Systematic Review

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