assessment of stromal invasion for correct histological diagnosis of early hepatocellular carcinoma正确评估基质入侵早期肝细胞癌的组织学诊断.pdfVIP

SAGE-Hindawi Access to Research International Journal of Hepatology Volume 2011, Article ID 241652, 7 pages doi:10.4061/2011/241652 Review Article Assessment of Stromal Invasion for Correct Histological Diagnosis of Early Hepatocellular Carcinoma Fukuo Kondo Department of Pathology, School of Medicine, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan Correspondence should be addressed to Fukuo Kondo, fkondo37@green.ocn.ne.jp Received 28 February 2011; Accepted 10 April 2011 Academic Editor: Ryosuke Tateishi Copyright © 2011 Fukuo Kondo. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Stromal invasion (invasive growth of tumor tissue into portal tracts and fibrous septa) is now recognized as the most important finding in the diagnosis of the well-differentiated type of early hepatocellular carcinomas (HCCs). In differentiating stromal invasion from pseudoinvasion (benign hepatic tissue in fibrous stroma), the following 5 items are useful: (1) macroscopic or panoramic views of the histological specimen, (2) the amount of fibrous components of stroma, (3) destruction of the structure of portal tracts, (4) loss of reticulin fibers around cancer cells, and (5) cytokeratin 7 immunostaining for ductular proliferation. Knowledge of stromal invasion is also useful for a better understanding of the vasculature (hypovascular HCCs) and histological features (fatty change) of early HCCs. Invasion of preexisting arteries and portal veins causes hypo-vascularity of HCCs. Further, hypovascularity causes fatty change as a hypoxic change of cancer tissues. 1. Introduction