Needle biopsy of hepatocellular carcinoma: Assessment of prognostic contribution of histologic parameters including proliferating cell nuclear antigen labeling and correlations with clinical outcomes
✍ Scribed by Françoise Chapel; Catherine Guettier; Claude Chastang; Antoine Abou Rached; Didier Mathieu; Maryline Tepper; Michel Beaugrand; Jean-Claude Trinchet
- Publisher
- John Wiley and Sons
- Year
- 1996
- Tongue
- English
- Weight
- 737 KB
- Volume
- 77
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
BACKGROUND.
Although many studies concerning the prognostic factors of resected hepatocellular carcinoma have been performed, the prognostic information provided by needle biopsy of these tumors has not yet been extensively studied.
METHODS.
One hundred twenty-four white patients with histologically-confirmed hepatocellular carcinoma were entered into a prospective study from 1990 to 1992 with followed-up through October 1994. Most of the patients had cirrhosis (79%). Patients were classified according to Okuda's staging: Stage I (50%), Stage I1 (47%), and Stage 111 (3%). The one-year survival rate was estimated at 58% in Okuda's Stage I, and 15% in Stages 11 and 111. Edmondson's grading, mitotic index, and proliferating cell nuclear antigen labeling index were studied on each biopsy. Univariate and multivariate analyses were performed to determine the prognostic significance of the different parameters.
RESULTS.
According to Edmondson's criteria, 13 of the hepatocellular carcinomas were Grade I, 63 Grade 11, 42 Grade 111, and 6 Grade N. There was a significant correlation between Edmondson's grade, mitotic index, and proliferating cell nuclear antigen labeling index (P < 0.01). Univariate analysis showed both the histologic grade ( P < 0.001) and mitotic index ( P < 0.05) correlated with survival. Cox's model indicated that Edmondson's grading yields additional prognostic information for Okuda's staging ( P < 0.001). The one-year survival rate for Okuda's Stage 1 was 76% for Edmondson's Grades I + I1 versus 23% for Grades 111 + N.