Pathological study of resected specimens of hepatocellular carcinoma after different ways of interventional treatment / 中华放射学杂志

ABSTRACT

Objective To investigate the pathological changes and its significance in resected specimens after three kinds of interventional therapeutic ways for hepatocellular carcinomas (HCCs). Methods Ten cases of HCCs were treated by conventional transcatheter hepatic arterial embolization (C-THAE) in group A, 10 cases were treated by segmental transcatheter hepatic arterial embolization (S-THAE) in group B, and 10 cases were treated by a combination therapy of C-THAE or S-THAE and percutaneous ethanol injection (PEI) in group C. There were constant clinical materials among three groups. All patients underwent resection in 4-8 weeks after the final interventional treatment. The resected specimens were studied by pathologists. Results Group B and group C were superior to group A with extraordinary remarkable difference on the tumor necrosis, the necrosis of invaded capsule, and the necrosis of tumor thrombus in portal vein. There was no significant difference between group B and group C. But the complete necrosis rates of the above-mentioned three indexes were improved from 80%, 71%, and 75% in group B to 100%, 83%, and 86% in group C,respectively. Collateral circulations inside capsule connecting portal vein in noncancerous hepatic tissues were found in group A (8 cases) and group B (2 cases). In addition, necrosis of pseudolobuli and degeneration or necrosis of hepatic cells were found on all sections of noncancerous hepatic tissues around tumor in patients treated by C-THAE, but the similar changes could be seen only on the sections within 1 cm near tumor. Conclusion S-THAE has much stronger ability to kill the tumors and much less damage on noncancerous hepatic tissues compared with C-THAE. PEI plays an important role in killing the residual tumors and improving the necrosis rates of invaded tumors in capsule and tumor thrombus in portal vein. It has also been proved that portal vein takes part in the blood supply of residual tumors.