小肝細胞癌の肉眼型分類からみた腫瘍特性 : 細胞増殖能とDoubling Timeの観点から

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  • Tumor cell proliferation and doubling time of small nodular hepatocellular carcinoma based on gross classification
  • ショウカン サイボウガン ノ ニクガンガタ ブンルイ カラ ミタ シュヨウ トクセイ サイボウ ゾウショクノウ ト Doubling Time ノ カンテン カラ

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It is reported that gross classification of hepatocellular carcinoma (HCC) is associated with tumors’ malignant behavior. We studied the characteristics and differences between two types of gross classification of HCCs (i.e. Boundary type: single nodular HCC; Nonboundary type: single nodular with extranodular growth, confluent multinodular, and invasive HCCs) by using MIB-1 labeling index (LI) and tumor volume doubling time (DT). 　 The DT of 87 HCCs, less than 5 cm in diameter at the start of the observation period, was calculated based on ultrasonographic images. The natural progression of the lesions were observed during 1 month or more. Regarding MIB-1 labeling index (LI) of the 87 lesions, we performed immunohistochemical staining (ABC method) with the MIB-1 monoclonal antibody using paraffin-embedded sections obtained by liver resection. The incidence of micrometastasis in the resected sections and the postoperative recurrence ratio were clearly higher in the nonboundary type (n=19) than in the boundary type (n=68). MIB-1 LI and DT were 12.1 +/- 1.3% (mean +/- SE) and 274.8 +/- 36.2 days in the boundary type and 14.2 +/- 2.0% and 103.9 +/- 13.4 days in the nonboundary type. A significant difference of DT was noticed between the 2 groups. 　 These results showed that the nonboundary type HCCs included tumors with rapid growth more than those in the boundary type. Calculating DT would assist in distinguishing gross classification preinterventionally and in determining suitable therapy such as liver resection and ablation.

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