Liver Surgery
Clinicopathological features and clinical significance of macrotrabecular-massive hepatocellular carcinoma
Wu Lixia, Wang Bin, Chen Yi, Wang Xuefang, Lin Kecan, Chen Lihong
Published 2022-10-08
Cite as Chin J Exp Surg, 2022, 39(10): 1869-1874. DOI: 10.3760/cma.j.cn421213-20220118-01020
Abstract
ObjectiveTo study the percentage of histological macrotrabecular massive type in hepatocellular carcinoma (hepatocellular carcinoma, HCC) and its effect on the prognosis of patients.
MethodsA total of 232 HCC cases who underwent surgery in Mengchao Hepatobiliary Hospital of Fujian Medical University from 2014 to 2016 were collected and histologically classified in detail, and the percentage of macrotrabecular-massive hepatocellular carcinoma (MT-HCC) was recorded. The threshold values of 10%-29%, 30%-49% and ≥ 50% were grouped, After excluding all recognized HCC subtypes, the remaining cases were considered traditional hepatocellular carcinoma (conventional type of HCC, CV-HCC). The general clinical data of patients was collected and the patients were follow-up after operation. T-test, chi square analysis and Kaplan Meier curve were used to compare the clinical and prognostic characteristics of MT-HCC and CV-HCC. Finally, univariate and multivariate COX regression was used to analyze the risk factors affecting the recurrence and prognosis of HCC.
Resultswhen the proportion of coarse beam histological subtypes in HCC was ≥ 10%, the clinicopathological characteristics were significantly different, which was defined as MT-HCC. There were 76 cases of MT-HCC and 156 cases of CV-HCC. The prognosis of MT-HCC is poor, and the average age of onset in patients with MT-HCC is lower than that in patients with CV-HCC (49.99 years old vs. 56.18 years old, t=-4.039, P<0.05), has a higher serum alpha-fetoprotein (AFP) level (58.49% vs. 29.41%, t=13.112, P<0.05), and the maximum diameter of tumor is larger than that of CV-HCC (8.12 cm vs. 4.28 cm, t=6.768, P<0.05). compared with CV-HCC, capsule invasion was more common (27.63% vs. 10.90%, t=10.448, P<0.05), more multinodular and massive tumors (t=24.567, P<0.05), higher histological grade (t=17.407, P<0.01) and higher AJCC stage (t=38.071, P<0.01). At the same time, it was more likely to see necrosis (85.53% vs. 42.31%, t=38.831, P<0.01), satellite focus (47.37% vs. 25.00%, t=11.688, P<0.01), macrovascular invasion (23.68% vs. 7.05%, t=12.926, P<0.01) and microvascular invasion (t=39.077, P<0.01).
ConclusionWhen the percentage of MT-HCC in HCC is ≥ 10%, it has obvious clinicopathological significance and and poor prognosis, so it should be described in the pathological report.
Key words:
Hepatocellular carcinoma; Histology; Tissue subtype; Macrotrabecular-massive hepatocellular carcinoma
Contributor Information
Wu Lixia
Department of Pathology, Mengchao Hepatobiliary Hospital, Fujian Medical University, Fuzhou 350025, China
Wang Bin
Department of Pathology, School of Basic Medicine, Fujian Medical University, Fuzhou 350004, China
Chen Yi
Department of Pathology, Mengchao Hepatobiliary Hospital, Fujian Medical University, Fuzhou 350025, China
Wang Xuefang
Department of Pathology, Mengchao Hepatobiliary Hospital, Fujian Medical University, Fuzhou 350025, China
Lin Kecan
Department of Hepatological Surgery, Mengchao Hepatobiliary Hospital, Fujian Medical University, Fuzhou 350025, China
Chen Lihong
Department of Pathology, School of Basic Medicine, Fujian Medical University, Fuzhou 350004, China
