The Clinicopathological and Prognostic Significance of the Gross Classification of Hepatocellular Carcinoma
Journal of Pathology and Translational Medicine
;
: 85-92, 2018.
Artículo
en Inglés
| WPRIM
| ID: wpr-741164
ABSTRACT
BACKGROUND:
We aimed to determine the clinicopathological significance of the gross classification of hepatocellular carcinoma (HCC) according to the Korean Liver Cancer Association (KLCA) guidelines.METHODS:
A retrospective analysis was performed on 242 cases of consecutively resected solitary primary HCC between 2003 and 2012 at Seoul National University Bundang Hospital. The gross classification (vaguely nodular [VN], expanding nodular [EN], multinodular confluent [MC], nodular with perinodular extension [NP], and infiltrative [INF]) was reviewed for all cases, and were correlated with various clinicopathological features and the expression status of “stemness”-related (cytokeratin 19 [CK19], epithelial cell adhesion molecule [EpCAM]), and epithelial-mesenchymal transition (EMT)–related (urokinase plasminogen activator receptor [uPAR] and Ezrin) markers.RESULTS:
Significant differences were seen in overall survival (p=.015) and disease-free survival (p = .034) according to the gross classification; INF type showed the worst prognosis while VN and EN types were more favorable. When the gross types were simplified into two groups, type 2 HCCs (MC/NP/INF) were more frequently larger and poorly differentiated, and showed more frequent microvascular and portal venous invasion, intratumoral fibrous stroma and higher pT stages compared to type 1 HCCs (EN/VN) (p < .05, all). CK19, EpCAM, uPAR, and ezrin expression was more frequently seen in type 2 HCCs (p < .05, all). Gross classification was an independent predictor of both overall and disease-free survival by multivariate analysis (overall survival p=.030; hazard ratio, 4.118; 95% confidence interval, 1.142 to 14.844; disease-free survival p=.016; hazard ratio, 1.617; 95% confidence interval, 1.092 to 2.394).CONCLUSIONS:
The gross classification of HCC had significant prognostic value and type 2 HCCs were associated with clinicopathological features of aggressive behavior, increased expression of “stemness”- and EMT-related markers, and decreased survival.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Pronóstico
/
Activadores Plasminogénicos
/
Análisis Multivariante
/
Estudios Retrospectivos
/
Clasificación
/
Carcinoma Hepatocelular
/
Supervivencia sin Enfermedad
/
Células Epiteliales
/
Transición Epitelial-Mesenquimal
/
Seúl
Tipo de estudio:
Guía de Práctica Clínica
/
Estudio observacional
/
Estudio pronóstico
País/Región como asunto:
Asia
Idioma:
Inglés
Revista:
Journal of Pathology and Translational Medicine
Año:
2018
Tipo del documento:
Artículo
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